Objective To investigate the clinical features and diagnosis and treatment of acute fatty liver of pregnancy ( AFLP) . Methods A retrospective analysis was performed for the clinical data of 12 patients with AFLP who were diagnosed and treated in Department of Infectious Diseases, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, from April 2012 to March 2017, including general data, clinical manifestations, laboratory markers, imaging examinations, treatment, and prognosis. Results All 12 patients developed AFLP in late pregnancy, and major clinical manifestations included gastrointestinal symptoms, liver failure, jaundice, and coagulation disorder. All patients were given multimodality therapy to protect the liver, improve coagulation, and reduce infection; 11 patients underwent cesarean section; 6 underwent blood filtration; 5 underwent plasma exchange. One patient died, resulting in a mortality rate of 8. 3%; 5 perinatal infants died, resulting in a mortality rate of 35. 7%. Conclusion In patients with AFLP, early diagnosis, timely termination of pregnancy, maximum symptomatic/supportive treatment, and control of infection, as well as the artificial liver support system, is the key to improving the prognosis of mothers and infants.