Liver nodules but normal alpha-fetoprotein may be caused by benign liver nodules or hepatocellular carcinoma, and some patients with hepatocellular carcinoma do not have elevated alpha-fetoprotein. Liver nodules may be benign nodules due to benign liver diseases such as cirrhotic nodules, hemangiomas, and hepatic adenomas, or malignant nodules due to malignant diseases such as primary hepatocellular carcinoma and metastatic hepatocellular carcinoma. Elevated alpha-fetoprotein (AFP) suggests the possible presence of primary liver cancer, but about 18% of patients with primary liver cancer do not have elevated AFP. And most patients with metastatic liver cancer and intrahepatic cholangiocarcinoma do not have elevated AFP. Therefore, hepatic nodules but normal AFP may be caused by benign liver disease or malignant tumor. Patients are advised to consult a specialist and undergo abdominal enhanced CT and puncture biopsy if necessary to further define the nature of the lesion.