In 2024, the American College of Gastroenterology released the recommendations for the diagnosis and management of common focal liver lesions based on the optimal evidence-based medicine evidence, including both solid and cystic liver lesions, making a comprehensive update to the 2014 edition of the guidelines for focal liver lesions. The guidelines introduce 51 key concepts and 18 detailed recommendations and provides a certain reference for the diagnosis and treatment of benign liver lesions in China. However, given the insidious onset and complex conditions of focal liver lesions, the difficulties in diagnosis, and the lack of high-grade evidence-based medicine evidence, the recommendations in the guidelines should serve as general guidelines rather than rigid protocols and should be used with reference to the situation of China. The guidelines set a benchmark for high-quality evidence-based hepatobiliary surgery guidelines, and the moderate- to low-grade evidence-based medicine evidence and controversies listed in the guidelines provide future directions for the research on focal liver lesions.