Drug-induced liver injury (DILI) is a disease caused by toxic injury or allergic reaction of drugs to the liver, also known as drug-induced hepatitis. DILI accounts for 2–5% of hospitalized liver patients in the USA, and about 25% of acute liver failure is caused by drugs, of which acetaminophen is the most common etiology. In China, DILI accounts for about 10% of hospitalized patients with acute hepatitis, and traditional Chinese medicine (TCM) is the main causative drug. The pathogenesis of DILI involves toxic injury to the liver, specific reactions to drugs, and interference with hepatic blood flow. Pathologic manifestations are diverse and include hepatocellular necrosis, inflammatory cell infiltration, cholestasis, and fatty liver. Imaging tests (CT and MRI) can be used to detect lesions and evaluate the disease. CT shows an enlarged liver with hypodensity or heterogeneous enhancement of the liver parenchyma; MRI shows homogeneous or heterogeneous enhancement of the liver parenchyma signal. The diagnosis of DILI needs to be made in conjunction with a history of drug use and imaging, and it needs to be differentiated from steatotic liver disease and other liver diseases.