This is a case of cryptogenic cirrhosis, male, 61 years old. Cryptogenic cirrhosis, also known as “idiopathic cirrhosis”, is not a specific type of cirrhosis after a thorough evaluation, and refers to cirrhosis in which the cause is not clear due to unknown medical history and difficulties in identifying the pathology of the tissue. Cryptogenic cirrhosis is reported to account for 5% to 30% of cirrhosis abroad, and is generally reported to be <5% in China. The etiology of cryptogenic cirrhosis can be viral infection, autoimmune liver disease, hepatomegaly, Dubin-Jison syndrome, alcoholic liver disease, non-alcoholic fatty liver disease, etc. In cryptogenic cirrhosis, the liver shows no or little necrosis or inflammation and no pathological damage of diagnostic significance (e.g., alcoholic hepatitis); it lacks specific tissue damage that can be demonstrated by histochemical staining, and serologic tests such as HBsAg, anti-HBC, anti-mitochondrial antibodies, anti-ribosomal, and plasma copper cyanide are normal. It is presumed that the majority are advanced manifestations of previously active, chronic or recurrent hepatitis, but alcoholic liver disease or other chronic liver disease can also cause a type of large nodular cirrhosis similar to cryptogenic cirrhosis. At least half of patients with cryptogenic cirrhosis have antiviral hepatitis C antibodies, so it is thought that these cirrhotic patients may be the result of chronic infection with hepatitis C virus. Some patients are also positive for hepatitis B surface antibodies, core antibodies, etc. The diagnosis of cryptogenic cirrhosis will gradually decrease with the increased understanding of liver disease and the continuous development of methods to detect hepatitis B and C viruses. Many foreign literatures report a high incidence of metabolic syndrome component diseases such as diabetes, obesity and hyperlipidemia in patients with cryptogenic cirrhosis, thus it is presumed that a very large proportion (30%-70%) of cryptogenic cirrhosis develops from non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH). In our study, the prevalence of abnormal glucose metabolism in cryptogenic cirrhosis was 53.45%, significantly higher than that of hepatitis B cirrhosis (36.59%). The pathological manifestations vary due to different causative factors. The liver varies in size and its surface can be distorted by large regenerative nodules, which can be as large as several centimeters in diameter, with the interstitial liver showing atrophy and fibrosis. The microscopic appearance of the liver shows regenerative nodules of the liver separated by connective tissue. Mononuclear cell infiltration may be present in the portal vein area, but the hepatocytes are well preserved and active hepatocyte necrosis or hepatocyte steatosis is rare or absent. Cryptogenic cirrhosis may be asymptomatic for many years and is often discovered accidentally during examination for other diseases. When clinical symptoms do occur, the signs and symptoms usually lack specificity, such as malaise, lethargy or those associated with portal hypertension such as ascites, splenomegaly, hypersplenism, esophageal varices, and hemorrhage. The liver is mostly normal or reduced in size, and an enlarged spleen is common. Ascites, spider nevi and abdominal wall varices may be present, and serum transaminases and bilirubin are usually normal or mildly elevated. Hyperglobulinemia is common and may be the only laboratory test abnormality. In conclusion, cryptogenic cirrhosis is increasingly becoming a common type of cirrhosis. Compared with hepatitis B cirrhosis, the patients with cryptogenic cirrhosis in this study were predominantly older and had a higher prevalence of abnormal glucose metabolism, but there was no difference in the prevalence of other metabolic syndrome-related diseases such as diabetes.