Abstract: Objective To evaluate the clinical features and predisposing factors of patients with acute drug-induced liver injury (DILI). Methods The clinical features, predisposing factors and medicine variation-tendency of 169 patients with acute DILI from Jan. 2008 to Dec. 2012 in our hospital were analyzed retrospectively. Results Most of the patients were female (56.80%), aged elder than 50 years (46.15%), and weigh less than 55 kilogram (64.50%). The clinical manifestation included one or more non specific symptoms, even 39 patients (23.08%) showed abnormal hepatic function firstly without any symptoms. Liver injury was slight (66.27%) or medium (22.49%) mostly, which included hepatocellular damage type (73.37%), mixed type (16.57%) and cholestasis type (10.06%). Many medicines might cause liver injury, of which the highest incidence rate was due to the use of Chinese herbal medicines (37.28%), antituberculosis drugs (21.30%) and antibiotics (17.16%). Furthermore, liver injury caused by Chinese herbal medicines seemed to rise year by year, while liver injury caused by antibiotics descended. After treatment, 81 patients (53.85%) were curable, 65 patients were improved (38.46%), while 17 patients were ineffective (10.06%) and 6 died (2.96%). Conclusions Various kinds of drugs could cause liver injury, and many patients had litter specific clinical manifestation. Clinician should grasp medication indication seriously and monitor untoward effects accurately.