Abstract: Acetaminophen, which is a very commonly used antipyretic and analgesic medicine in clinical practice, can easily induce liver injury. It is generally thought that the mechanism of acetaminophen-induced liver injury involves oxidative stress, mitochondrial damage, inflammation, etc.. Researches show that mitochondria is an important target for acetaminophen-induced liver damage. From the perspective of metabolism and immunity, this paper attempts to uncover the molecular mechanism of acetaminophen in hepatic injury from destruction of mitochondrial structure and function through the metabolites of acetaminophen and activation of liver immune response, with an exploration of the potential therapeutic methods based on antioxidation and repair of damaged mitochondria.