Objective To discuss the liver tissue pathology characteristics， HBV DNA levels and TCM syndrome distribution of chronic hepatitis B patients with persistent normal ALT level under the etiologies of Hepatitis b virus（HBV） HBeAg positive and HBeAg negative. Observe and analyze the connection with each other in support of traditional Chinese medicine dialectical treatment. Methods Screening 34 cases of HBeAg positive and 58 cases of HBeAg negative chronic hepatitis B patients with persistent normal ALT level who were hospitalized in our hospital from April 2012 to June 2014， and compared their liver tissue pathology characteristics， HBV DNA levels and TCM syndrome distribution. Results The average age of HBeAg positive patients was less while the HBV DNA levels was higher than HBeAg negative patients’. Among 92 cases of chronic hepatitis B patients， the principal TCM syndrome were the syndrome of liver-depression and spleen-deficiency and the syndrome of humid heat to hinder type， accounted for 45.7% and 33.7%， respectively；the primary inflammatory activity was G2， and the syndrome of liver-depression and spleen-deficiency and the syndrome of humid heat to hinder type accounted for 33.7% and 30.4%， respectively；the main fibrosis grading was S2， and the syndrome of liver-depression and spleen-deficiency and the syndrome of humid heat to hinder type accounted for 37.0% and 27.2%， respectively； the degrees of liver inflammation and fibrosis for the patients of blood stasis syndrome were serious than any other syndromes. The HBV DNA level of humid heat to hinder type syndrome was higher than the others. Conclusion The liver tissue pathologies and HBV-DNA levels of chronic hepatitis B patients have certain correlation with TCM syndrome.