Echo thickening on ultrasound of the liver is usually a sign of diffuse liver lesions. When a patient has an infectious disease, such as hepatitis B, A or C, in the early stages of hepatitis, the liver will be mildly enlarged, however, the envelope, parenchyma, is not significantly altered. As the lesions damage the liver severely, cirrhosis may develop, with the liver’s envelope not being smooth, the volume becoming smaller, and the parenchymal echogenicity of the liver thickening and becoming uneven. Cirrhosis can also turn into liver cancer, and ascites can develop. When a patient has hepatic schistosomiasis, the liver parenchyma will also be thickened, which is now rare with improved hygiene. Some patients with chronic diseases and long-term use of certain drugs can also cause liver damage and thicken the liver parenchyma, requiring patients to have regular liver function tests to avoid more serious consequences.