Hypoechoic areas on ultrasound usually refer to areas that have no occupying effect, unlike solid tumors that have a three-dimensional appearance. Areas without fatty deposits on the basis of fatty liver are often hypoechoic, or areas with less fatty deposits can also be hypoechoic, most often occurring next to the gallbladder and next to the ligament of the left lobe of the liver, and hypoechoic areas can also show inflammatory changes. Hypoechoic areas should be followed to see if they increase in size and if there are other changes in the echogenicity. Hypoechoic areas must be combined with other imaging tests to clarify the nature of the area. Enhanced CT, enhanced MRI, or ultrasonography can be performed to clarify the nature of the hypoechoic area and to define the options for further investigation and treatment.