Abstract: OBJECTIVE To explore the liver function damage in enteritis children with rotavirus (RV) and and its relationship with Toll-like receptor 4/nuclear factor kappa B p65 (TLR4/NF-κB p65) pathway. METHODS Total of 110 children with enteritis infected with RV admitted to the hospital between Jan 2019 and Jun 2021 were enrollled as the RV infection group, and another 80 children with enteritis and negative RV infection treated during the same period were enrolled as the control group.Automatic biochemical analyzer was used to detect the liver function of the children, such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels.And polymerase chain reaction was performed to detect the relative expression levels of TLR4 mRNA and NF-κB mRNA, and Western blot was adopted to detect the protein expression level of NF-κB p65 of leukocytes in peripheral blood.Enzyme-linked immunosorbent assay was applied to detect the levels of serum tumor necrosis factor (TNF-α), interleukin-1β (IL-1β) and IL-6, and the relationship between liver function and TLR4/NF-κB p65 pathway was analyzed. RESULTS The levels of ALT and AST and liver injury rate in the RV infection group were higher than those in the control group (P＜0.05).The expression levels of TLR4 mRNA, NF-κB mRNA and NF-κB p65 protein and levels of serum TNF-α, IL-1β and IL-6 were higher in the RV infection group than those in the control group (P＜0.05).The levels of ALT and AST in children with enteritis and RV infection were positively correlated with the expression levels of TLR4 mRNA, NF-κB mRNA and NF-κB p65 protein and levels of serum TNF-α, IL-1β and IL-6 (ALT: r=0.483, 0.564, 0.416, 0.348, 0.560, 0.314, P＜0.05; AST: 0.537, 0.457, 0.312, 0.434, 0.572, 0.399, P＜0.05). CONCLUSION Children with enteritis infected with RV are prone to have liver injury, which is related to the excessive activation of TLR4/NF-κB p65 pathway.