Abstract: Objective To investigate the relationship and clinical significance between interleukin 18 (IL-18) expression in liver tissues and CHB patients with different prognosis. Methods Total of 230 CHB patients in the Second Affiliated Hospital of Anhui Medical University were enrolled. The tissue specimens were obtained by liver biopsy from all patients, and 21 normal liver specimens were also collected as controls. The liver function and liver inflammation grades and fibrosis stages were assessed. Immunohistochemical method was used to detect the expression of IL-18 in liver tissues. Spearman rank correlation was used to analyze the correlations between IL-18 expression and the above indicators. Results IL-18 was mainly expressed in the cytoplasm of hepatocytes. The difference of IL-18 expression level between CHB patients and healthy people has statistically significance (P ＜ 0.05). In patients with HBV infection, the expressions of IL-18 are gradually increased with elevated levels of alanine aminotransferase, aggravating the degrees of inflammation and fibrosis (r = 0.184, 0.169, 0.085, all P ＜ 0.05). Conclusions The expression of IL-18 may be involved in liver injury and disease progression in CHB.