Liver calcification foci is an ultrasound diagnostic term that refers to the appearance of strong echogenic or dense images like stones in the liver on ultrasound or CT images. There are many causes, such as parasitic infections, tumors, chronic inflammation or trauma in the liver, and intrahepatic structures (blood vessels, bile ducts, lymphatic vessels) that can become calcified, and a thorough examination and analysis is needed to determine this. In fact, calcified foci within the liver and fibrotic scarring of localized necrosis of liver tissue may present strong echogenic masses and acoustic shadows similar to stones, but generally do not cause dilatation of the hepatobiliary ducts. In contrast, stones have dilation in the small bile ducts above the site of obstruction, and the strong echogenic masses of stones have a characteristic distribution along the left and right hepatic ducts. For this type of intrahepatic calcification, no treatment is required. For prudence, these calcified foci can be followed up for up to 2-3 years, with follow-up ultrasound examinations every 3-6 months. Among benign tumors of the liver, calcification of cavernous hemangioma of the liver is most common. Calcification of the fibrous septum and small vessels separating the tumor may occur in the form of spots or strips. Calcification in primary hepatocellular carcinoma is rare, with an incidence of only 0.36%-1.2%. It is mostly seen in fibrous lamellar hepatocellular carcinoma and hepatoblastoma, with the former mostly seen in adolescents and the latter mostly in children under 5 years old, with calcification foci appearing inside the tumor in the form of stars or nodules. Calcified foci of intrahepatic metastases are cancer foci formed by metastases of malignant tumors from other sites to the liver, mostly seen in lesions with a diameter of 3 cm or more, and less often in lesions less than 2 cm. The typical ultrasound image of metastases is a “bull’s eye” sign, i.e. hypoechoic at the edge and hyperechoic at the center. The CT presentation of metastases is also varied, showing sand-like calcifications, irregular patchy or speckled calcifications. In conclusion, there is no obvious regularity in the distribution and morphology of calcified foci in metastases. Those who suspect calcified foci of intrahepatic metastases should firstly consider metastases of colorectal cancer, followed by metastases of breast cancer, gastric cancer, thyroid cancer, ovarian cancer, lung cancer, smooth muscle sarcoma, islet cell tumor, osteosarcoma and melanoma, and therefore should actively search for the primary cancer foci. Calcification can also occur in liver parasitic diseases, commonly hepatic encysticercosis and hepatic schistosomiasis, the former mostly in herders and the latter mostly in farmers and fishermen in infected areas. The lesions in the liver of hepatic encystment are numerous small vesicles with diffuse infiltrative growth, indistinctly bounded by normal liver tissue and with calcium salt deposits in the cystic bases. On ultrasound images, the cysts are strongly echogenic with acoustic shadowing, and CT shows vague irregularity of the lesion edges, extensive granular or indeterminate calcifications are visible, and liquefied necrosis may occur in the central part of the lesion. Ultrasound and CT images of hepatic schistosomiasis show various manifestations depending on the degree of infection. The characteristic images are calcification of the liver envelope and spacer-like calcification of the liver parenchyma, which together form a “map liver” or “turtleback-like” manifestation. Chronic inflammation in the liver is more common in hepatic tuberculosis and liver abscess, and less common in mycosis, brucellosis, portal vein thrombosis, and nodular disease. In conclusion, there is no need to be blindly afraid and scared of intrahepatic calcified foci, first of all, we should exclude primary or secondary tumors of the liver, then we should distinguish between liver infection and inflammation, and most importantly, we should go to a regular hospital for treatment, only when the cause is clear can we take targeted treatment.