The liver is one of the organs most commonly affected by rheumatic diseases. Hepatic abnormalities in patients with rheumatic diseases can result from a variety of factors，including direct liver involvement by the disease itself，coexistence with primary liver disease，and drug-induced liver injury. When liver indicators are abnormal，a thorough differential diagnosis is required. For unexplained liver dysfunction，routine testing for autoantibodies should be performed to facilitate early identification of underlying autoimmune liver disease. If the etiology remains unclear，a liver biopsy is recommended for a final diagnosis if feasible. Alongside active management of rheumatic diseases，it is necessary to closely monitor liver function，avoid the use of agents that may exacerbate hepatic damage，particularly anti-rheumatic drugs with strong hepatotoxicity，and tailor treatment strategies according to personal specific conditions，so as to minimize liver damage and improve long-term outcome.