Radiation-induced liver injury (RILI), also known as radiation-induced liver disease (RILD) and radiation hepatitis (RH), is a physiological and pathological condition caused by a certain dose of radiation irradiation. It is characterized by veno-occlusive disease (VOD) pathological change and is closely associated with the total dose and volume of radiation, as well as underlying liver conditions and other factors. RILI can be divided into different stages based on the time of injury and can be diagnosed through various imaging modalities such as radionuclide scans, ultrasound, CT, and MRI. The imaging manifestations include reduced radionuclide uptake, changes in liver echoes and density/signal, and specific enhancement patterns on enhanced scans. Differential diagnosis includes primary liver cancer recurrence, localized inflammation, and focal fatty liver. The diagnostic points of RILI require a history of radiotherapy, abnormal imaging findings corresponding to irradiation range, absence of related symptoms, and no excessive changes in biochemical indices.