The association of high amplitude echoes returned from the cirrhotic liver and fatty liver is well recognized. And some degree of correlation between the severity of histologic change and tissue echo pattern was reported. It has been suggested that ultrasonography can predict parenchymal disease by variations in the intensity and pattern of the reflected sound waves. To test the correlation of hepatic parenchymal echogenicities with the severities and types of pathologic changes, such as inflamation, necrosis, fibrosis and fatty change, we have compared the echogenicities with the types and severities of pathological changes of liver observed with peritoneoscopic biopsy in 66 patients witn liver diseases 7 with cirrhosis, 18 chronic active hepatitis with cirrhosis, 19 chronic active hepatitis, 5 chronic per- sistent hepatitis, 10 fatty liver, 9 acute unresolved hepatitis and 8 minimal inflamation. The ultrasonography and peritoneoscopic liver biopsy were done within 5 days interval. There was a good correlation between the echogenicity of liver and the severity of fatty change but no correlation between echogenicity and severity of the other pathologic changes such as inflammation, necrosis and fibrosis.