Hepatitis B hyperechoic nodules are not necessarily cancerous, but may also be hepatic hemangiomas, intrahepatic bile duct stones or intrahepatic calcified spots. 1. Hepatic hemangioma: it is a benign tumor of liver originated from endothelial cells of blood vessels. Typical ultrasonographic manifestations are homogeneous, strongly echogenic intrahepatic occupations with clear margins and enhanced acoustic shadows on the posterior wall, and small hypoechoic areas may appear in the center. There are no obvious symptoms in the early stage, but when the tumor is large, it may produce epigastric discomfort, pain, vomiting and other compression symptoms. 2. Intrahepatic bile duct stones: ultrasonography can show strong echoes in the intrahepatic bile ducts and their posterior acoustic shadows, which can be used to diagnose intrahepatic bile duct stones, and if dilatation of the bile ducts proximal to the stone is observed, the diagnosis can be confirmed. Diagnosis can also be assisted by CT and imaging. It is mainly associated with biliary tract infection, biliary parasites, biliary stasis, and malnutrition. Some patients may have epigastric and thoracic back distension and discomfort. 3. Intrahepatic calcified spots: It refers to the appearance of strong echoes or high-density images similar to stones in the liver on ultrasound or CT images, which is usually a single calcified foci, and is mostly seen in the right liver. It has no effect on liver function, physiology and daily life. Intrahepatic calcified foci may occur in hepatitis, liver abscess, parasitic infection, and calcification of intrahepatic metastases. Hepatitis B hyperechoic nodules are not necessarily cancerous, but may also be other diseases. Doctors need to make a comprehensive judgment based on the patient’s clinical manifestations, imaging and laboratory tests, etc., to diagnose the disease and then treat it symptomatically, so as to prevent delaying the condition.