The causes of elevated transaminases include viral hepatitis, alcoholic liver disease, fatty liver, drug induced liver injury, autoimmune liver disease, staying up too late, and excessive exercise. Transaminases are widely present in myocardium, brain, liver, kidney and other tissues, and liver is the main place where transaminases exist. When liver inflammation or toxicity exists hepatocytes are damaged, and transaminases in hepatocytes are released into the bloodstream, causing elevation of serum transaminases. Certain physiologic or pathologic factors can cause elevation of serum transaminases. Physiologic factors such as strenuous exercise, physical activity, late nights, and menstruation in women can all be attributed to elevated transaminases. Alcoholism, malnutrition, viral hepatitis, liver trauma, cirrhosis, hepatocellular carcinoma, myocarditis, pancreatitis can cause elevation of serum transaminases. Patients who find elevated transaminases during physical examination should immediately seek medical attention, complete abdominal ultrasound, cardiac ultrasound and other examinations, and follow the doctor’s instructions for treatment.