A fatty liver may present with hypoechoic masses. Fatty liver is a disease characterized by excessive fat storage and steatosis in hepatocytes. Its echogenic mass is primarily utilized to characterize the propagation of ultrasound through adipose tissue, which appears to be significantly attenuated, as well as to quantify the degree of hepatic steatosis. Hypoechoic clusters can be seen in conditions such as fatty deposits in the liver and inhomogeneous fatty liver. Therefore, hypoechoic clusters can be seen in patients with fatty liver when these conditions are present. In addition, it is recommended that patients with fatty liver with hypoechoic mass should go to the hospital in time, do relevant examination to clarify the cause of the disease, and then follow the doctor’s instructions for treatment to avoid delaying the condition. Fatty liver is closely related to dietary habits and exercise management, and those who have irregular dietary habits, work and rest, and neglect exercise are very prone to recurrence. Therefore, it is necessary to pay attention to the usual health management and change the bad lifestyle such as staying up late.