Fatty liver is a common diffuse liver disease that can be reversed if treated promptly; conversely, some patients can develop steatohepatitis or even cirrhosis. Therefore, early diagnosis and treatment is important to stop the progression of fatty liver and improve the prognosis. In recent years, with the development of imaging technology, especially the wide application of CT, MRI and ultrasound imaging in clinical practice, a more accurate clinical diagnosis can no longer be made by liver puncture biopsy. Due to the lack of specific clinical manifestations and laboratory indices of fatty liver, and the invasiveness of liver puncture biopsy, ultrasound and CT are now mainly used to diagnose fatty liver. It has been confirmed that imaging can not only screen for fatty liver but also confirm the diagnosis. Given that ultrasound has the advantages of being economical, rapid and non-invasive in diagnosing fatty liver, regular ultrasound examination of the liver for people at high risk of fatty liver is the best method for early detection of fatty liver. People at high risk for fatty liver are those who have risk factors for the development of fatty liver and are more likely to develop fatty liver than the general population. The main risk groups for fatty liver include obesity, especially visceral fatty obesity; diabetes mellitus, especially adult non-insulin-dependent diabetes mellitus; chronic heavy alcohol drinkers; hyperlipidemia, especially those with elevated blood triglycerides; long-term users of liver-damaging drugs; and individuals with a family history of obesity, diabetes mellitus and fatty liver. In conclusion, people with risk factors for the development of fatty liver should be aware of self-care and should undergo regular (1 to 2 times a year) liver ultrasound and other imaging examinations for early detection of fatty liver.