Drug-related liver injury refers to the application of therapeutic doses of drugs, the body by the drug or its metabolites produced by the toxic effects, or allergic reactions caused by liver damage. Drug-related liver injury is 90% of acute liver injury, 3% to 10% of chronic liver injury and liver failure. Among all adverse drug reactions worldwide, the incidence of drug-related liver damage is 10%-15%, and fulminant liver failure is 5%. In the United States, 20% of jaundice in the elderly is caused by drugs, and 25% of fulminant liver failure is caused by drugs, especially paracetamol overdose, with a death rate of more than 50%. In Japan, the incidence of DILI increased 10-fold from 1964 to 1973. In France, drug-induced liver disease accounts for 10% of patients with hepatitis, and 40% of these patients with liver injury are over 50 years of age. The incidence of drug-induced liver injury in China is also increasing year by year. Currently, due to the large variation in the onset of drug-related liver injury, the hidden relationship between clinical manifestations and drug use, and the excitement of most hepatologists for viral hepatitis, there is no good confirmatory method and diagnostic criteria, so it is often underdiagnosed and misdiagnosed. When there is difficulty in clinical diagnosis, RUCAM scoring system and Maria scoring system can be applied to assist in diagnosis I retrospectively analyzed the clinical data of 230 patients with acute drug-related liver injury hospitalized in Beijing Ditan Hospital between October 2005 and May 2011 (using RUCAM quantitative scoring system) and found that among 230 patients, 99 cases (43%) were males ,131 female (57%), age 19-84 years, mean age (51.8±16.8) years. The most common drugs causing liver injury were herbal tonics and Chinese patent medicines, anti-tuberculosis drugs and other anti-bacterial drugs. The more common herbal medicines included: He Shou Wu, Bai Xian Pi, Yan Hu Suo, Retention of urine, Compound Qing Dai capsule, Neck Shu, Jin Wu Bone Pain capsule, Vitiligo capsule, Xiao Jin Wan, etc. The western medicines included: anti-tuberculosis drugs (isoniazid, rifampin, pyrazinamide), antibiotics (amoxicillin, gatifloxacin, metronidazole), lipid-lowering drugs (simvastatin, atorvastatin, fenofibrate), etc. Among 230 patients 94.7% of patients had a good prognosis, 4 cases were discharged automatically with exacerbation, and 8 cases died. In conclusion, the incidence of drug-related liver injury is on the rise year by year, and there is no good method to confirm the diagnosis, which can be combined with a scoring system to assist in the diagnosis. When taking drugs that may harm the liver, attention should be paid to monitoring liver function, and once drug-related liver injury occurs, suspicious drugs should be immediately discontinued, and anti-inflammatory and liver-protective drugs should be actively treated.