Abstract： Objective： To investigate the relationship between traditional Chinese medicine (TCM) syndrome types and ultrasonic parameters of nonalcoholic fatty liver disease (NAFLD). Methods：A total of 120 cases with NAFLD admitted to Nanxun Branch of Zhejiang Hospital of Traditional Chinese Medicine from March 2019 to March 2022 were retrospectively selected as the research objects. According to the TCM syndrome types， patients were divided into five groups： syndrome of liver constraint and spleen deficiency (46 cases)，syndrome of internal retention of damp- turbidity (25 cases)，syndrome of damp- heat accumulation (21 cases)， syndrome of phlegm blended with stasis (17 cases)， and syndrome of spleen- kidney deficiency (11 cases). The levels of body mass index (BMI)， alanine aminotransferase (ALT)， aspartate aminotransferase (AST)， glutamyl transpeptidase (GGT)， triglyceride (TG)， cholesterol (TC) and low density lipoprotein (LDL) in all groups were compared. The ultrasonic fatty liver grading， acoustic attenuation imaging parameters (ATI) and controlled attenuation parameters (CAP) were compared between the groups. Results：The levels of BMI，ALT，AST，GGT and TG in the group of syndrome of phlegm blended with stasis and the group of syndrome of spleen- kidney deficiency were significantly higher than those in the group of syndrome of liver constraint and spleen deficiency，the group of syndrome of internal retention of damp- turbidity and the group of syndrome of damp- heat accumulation (P＜0.05). There was no significant difference in the levels of TC and LDL in the all groups and in the levels of BMI， ALT，AST，GGT and TG in the group of syndrome of liver constraint and spleen deficiency，the group of syndrome of internal retention of damp- turbidity and the group of syndrome of damp- heat accumulation (P＞0.05). The levels of CAP and ATI in the group of internal retention of damp- turbidity， the group of syndrome of damp- heat accumulation， the group of phlegm blended with stasis and the group of syndrome of spleen-kidney deficiency were higher than that in the group of syndrome of liver constraint and spleen deficiency (P＜0.05)；the levels of CAP and ATI in the group of phlegm blended with stasis and the group of syndrome of spleen-kidney deficiency were higher than those in the group of syndrome of internal retention of damp- turbidity and the group of syndrome of damp- heat accumulation (P＜0.05). The proportion of mild fatty liver in the group of syndrome of liver constraint and spleen deficiency was larger than that in the group of syndrome of internal retention of damp-turbidity，the group of syndrome of dampheat accumulation， the group of syndrome of phlegm blended with stasis and the group of syndrome of spleen- kidney deficiency (P＜0.05)； the proportion of moderate fatty liver in the group of syndrome of internal retention of damp-turbidity and the group of syndrome of damp-heat accumulation was larger than that in the group of syndrome of liver constraint and spleen deficiency，the group of syndrome of phlegm blended with stasis and the group of syndrome of spleen- kidney deficiency (P＜0.05)； the proportion of severe fatty liver in the group of syndrome of phlegm blended with stasis and the group of syndrome of spleen- kidney deficiency was larger than that in the group of syndrome of liver constraint and spleen deficiency， the group of syndrome of internal retention of damp- turbidity and the group of syndrome of damp- heat accumulation (P＜0.05). Correlation analysis showed that CAP and ATI levels were positively correlated with ultrasonic grading of fatty liver (P＜0.05). Conclusion：The TCM syndrome types of NAFLD patients is correlated with ultrasonic grading，CAP，ATI and other parameters of fatty liver. The ultrasonic fatty liver classification in patients with syndrome of phlegm blended with stasis or with syndrome of spleen-kidney deficiency is mainly severe，with high CAP and ATI levels.