Abstract: Fatty liver is increasingly common in patients with chronic hepatitis B (CHB) in China. The impact of hepatitis B virus infection on fatty liver and metabolism , in turns the impact of fatty liver and metabolic factors on the development and treatment of patients with CHB are of great concern .The causes of abnormal elevation of serum aminotransferases in patients with CHB and fatty liver should be carefully determined to make appropriate therapeutic choices in these conditions.In order to make personalized treatment and follow-up measures, the non-invasive diagnosis for nonalcoholic steatohepatitis in patients with chronic hepatitis B virus infection requires further studies.