Liver injury has become a serious liver disease worldwide, and its incidence is increasing year by year, bringing a serious health burden to people in all countries. Tetrahydrocurcumin is an active metabolite of curcumin, which has pharmacological effects such as antioxidant, anti-inflammatory, inhibition of apoptosis, anti-tumor, and anti-aging, and it can inhibit apoptosis in liver cells under the state of hepatic injury and reduce the level of oxidative stress and inflammation in liver tissues through the signaling pathways such as MAPK, PI3K/Akt, PPAR, AMPK, and Nrf2 to prevent and control liver injury. The purpose of preventing and controlling liver injury can be achieved. The active structure, pharmacological effects and application of tetrahydrocurcumin in liver injury were summarized by reviewing domestic and international literature, with a view to providing reference for further research on tetrahydrocurcumin in the field of liver injury.