Intrahepatic spotty calcified density shadow represents a hyperdense or hyperechoic image inside the liver, indicating the possible presence of intrahepatic calcified foci or intrahepatic bile duct stones. 1. Intrahepatic calcified foci: Patchy calcified foci are scarring reactions that occur when liver cells recover from necrosis caused by inflammation or trauma. For this kind of intrahepatic spot-like calcified density shadow, it is necessary to check whether there are factors leading to liver damage, such as hepatitis B, drug liver damage, autoimmune liver disease, etc. Early detection and treatment can effectively prevent liver cell damage from aggravating. 2. Intrahepatic bile duct stones: patients with intrahepatic bile duct stones may also have intrahepatic speckled calcified density shadows; magnetic resonance cholangiopancreatography can be done to further determine whether there is a possibility of intrahepatic bile duct stones. Most intrahepatic calcified foci are found incidentally during physical examination. If there are no obvious signs and symptoms, patients who exclude the above pathologic factors and have normal liver function can be followed up regularly. It is recommended that patients with intrahepatic speckled calcified density shadows should seek prompt medical attention to identify the cause and then target treatment.