Liver failure and intestinal barrier injury, especially intestinal microflora imbalance, interacts as both the cause and effect of each other. Intestinal barrier injury is observed during liver failure, including the injuries of chemical, mechanical, immune, and microbial barriers, and meanwhile, gut dysbiosis, increased bacterial endotoxins, and abnormal bile acid metabolism may affect hepatocyte regeneration, increase complications, and aggravate the conditions of liver failure. The maintenance of intestinal barrier function should be taken seriously in the treatment of liver failure, and the treatment targeting intestinal barrier injury, especially microecological disturbance, is a promising method.