Thickened and uneven liver, normal size, smooth pericardium, and normal intrahepatic ductal alignment are descriptive of the liver on ultrasound. It is common in alcoholic liver, fatty liver, drug liver injury, early cirrhosis and other causes. 1. Alcoholic liver: long-term alcohol consumption will easily affect the normal metabolic function of the liver, which will lead to abnormal liver function. In early stage, liver echogenicity can be thickened and uneven by ultrasonography, but the size, periphery and intrahepatic ductal structure are normal. 2. Fatty liver: Uneven fatty liver can occur when the surface fat coverage of liver is not uniform, and uneven liver thickening echoes can occur in ultrasonography, but other forms of size, envelope and tubular structure are normal. It is often accompanied by obesity, irregular diet and other bad factors. 3. Pharmacological liver injury: long-term use of certain drugs or chemical drugs can affect the liver metabolism, or due to the patient’s special physical hypersensitivity to drugs or reduced tolerance, which can lead to liver injury, such as common tuberculosis drugs, tumor drugs and so on. Ultrasonography after drug-related liver injury can show uneven thickening of liver parenchyma, often accompanied by abnormal liver function. 4. Early cirrhosis: Early cirrhosis patients can only have simple uneven thickening of liver parenchyma in ultrasonography, and laboratory tests can show abnormal liver function. When uneven thickening of liver parenchyma occurs in liver ultrasonography, it is necessary to go to the hospital for examination and treatment in time to avoid delaying the condition.