Pancreatic parenchymal echogenicity is a manifestation of pancreatic ultrasonography, which may be due to acute pancreatitis, chronic pancreatitis, pancreatic cancer and other causes. 1. Acute pancreatitis: pancreatic enzyme secreted by pancreas for self-digestion and premature activation leads to pancreatitis, which results in parenchymal edema and peripancreatic necrosis of pancreatic tissues, which can be manifested as rough and inhomogeneous pancreatic parenchymal echogenicity in ultrasonography. 2. Chronic pancreatitis: chronic pancreatitis is characterized by reduction of pancreatic alveolar tissue and fibrosis, which is manifested by fibrosis and atrophy of pancreatic tissue as well as infiltration of mononuclear cells, which can be manifested as coarsening of pancreatic echogenicity in ultrasonography. 3. Pancreatic cancer: pancreatic cancer leads to destruction of normal pancreatic tissues, which can be characterized by rough and uneven echogenicity in ultrasound, meanwhile, ultrasound can also check the obstruction of pancreatic ducts caused by the tumor. Pancreatic parenchymal echogenic roughness may be due to other reasons, which should be promptly consulted in the hospital, further examination to clarify the cause of the disease, and active treatment or treatment.