About 1% of the patients with acute hepatitis B can progress to acute liver failure, and 75% of the patients with hepatitis B virus (HBV)-related acute liver failure need to undergo liver transplantation or face death. This article reports a patient with HBV infection-related acute liver failure who achieved clinical cure and HBsAg seroconversion after antiviral therapy and symptomatic/supportive treatment, and dynamic monitoring was performed for immunological markers in peripheral blood.