With the increasingly wide application of herbal medicines and dietary supplements worldwide， herb-induced liver injury （HILI） has become an important etiology of drug-induced liver injury. Due to the diverse manifestations of HILI， the difficulty in medical history collection， and the lack of specific biomarkers， how to identify suspected patients and make a correct diagnosis has become a major challenge in practice. Causality assessment is commonly used in the diagnosis of HILI， but there is still a lack of prospective cohort studies with a large sample size. In addition， further studies are needed to search for the specific biomarkers for the diagnosis of HILI. The diagnosis and differential diagnosis of HILI are challenging， and currently there is still no universally accepted uniform and standard method for the diagnosis of all-cause HILI.