Abstract: To outline the clinical features of liver damage in severe acute respiratory syndrome (SARS) patients with systemic inflammatory reaction syndrome (SIRS) , in order to elucidate the pathogenesis of SARS. Retrospective case series involving 128 patients with a certain diagnosis of SARS was included in our study, whose clinical and laboratory data were collected and analyzed. Serum inflammatory factors of 32 patients were determined by ELISA method in various stage of SARS. 10 cases were examined with B type ultrasound and autopsy of 3 cases were performed. ①Besides lung damage, abnormalities of other organs such as heart and kidney, especially liver, were found in 75.8% cases; ②Aminotransferase, cardiac enzymes and inflammatory factors elevated mainly in the first two weeks of SARS and decreased while recovery. Progressive decline of serum albumin indicated poor prognosis. Continuous high level of creatinine and urea nitrogen was seen in the end stage of some severe patients. ③Ultrasonic and pathological findings showed that there was non-specific inflammatory changes in liver. Liver injury is common in SARS which is a consequence of systemic inflammatory reaction syndrome. It may be beneficial to suppress the cytokine storm in patients of SARS with SIRS and to release pulmonary, hepatic, cardiac damage and improve their prognosis.