Chronic liver disease is a significant global health burden，accounting for 3.5% of all deathsworldwide each year. Serum endotoxin level is closely related to end ⁃stage liver disease ，which can cause oraggravate liver injury in direct or indirect way. However，the specific role of endotoxemia in liver injury is not yetclear. The latest gut⁃liver axis related studies found that the role of endotoxin in the progression of liver injurymay be seriously underestimated. Therefore，this article focuses on the mechanism and role of endotoxemia in theoccurrence and development of chronic liver disease，thus to provide theoretical basis for clinical guidance for thetreatment of chronic liver disease.