Dense hepatic parenchymal echogenicity may suggest hepatocellular injury or increased hepatic parenchymal density. 1. Hepatocellular injury. Common clinical causes of liver damage mainly include viral hepatitis, alcoholic liver disease and fatty liver. Hepatitis virus, alcohol and fat droplets that exceed the metabolic capacity can cause different degrees of damage to liver cells, which will correspond to the appearance of dense liver parenchyma under ultrasound. 2. Increased density of liver parenchyma. Dense hepatic parenchyma echogenicity may also indicate increased density of the liver parenchyma, which may be caused by fatty liver, bruising, etc. Further investigations such as enhanced CT are needed to rule out or confirm the diagnosis. In conclusion, dense liver parenchymal echogenicity is an abnormal condition, and it is recommended to consult a doctor promptly to identify the specific cause in order to choose an appropriate treatment plan.