Tongue fat with teeth marks is considered by TCM to be mostly related to spleen deficiency, water-drinking, phlegm-dampness stagnation, and is generally not much associated with liver depression (i.e., liver-qi stagnation). Tongue observation is one of the characteristic diagnostic methods of Chinese medicine, which refers to the method of diagnosis by observing the tongue, which is the image composed of the color and shape of the tongue texture and the tongue moss. Tongue fat with teeth marks can be generally categorized as fat tongue, teeth marks tongue category, the cause of which is mostly due to the spleen deficiency without the ability to transport and transform water and dampness, so that the water, drink, phlegm and dampness impeded in the tongue and tongue fat, and by the teeth of the extrusion and the formation of teeth marks. Tongue fat with teeth marks is not generally associated with liver qi stagnation, but liver qi stagnation can affect the elevation of spleen and stomach qi, resulting in spleen and stomach dysfunction, which may exacerbate the spleen deficiency. Specific identification and analysis should be combined with the patient’s own other specific symptoms, and analyzed by a professional physician. If the patient is not feeling well, it is recommended to consult a doctor in time and standardize the treatment.