Hepatitis E is an infectious disease caused by hepatitis E virus（HEV）infection，which is a significant public health concern worldwide. Although hepatitis E is generally considered an asymptomatic，self-limiting disease，its clinical manifestations vary， some patients may develop severe or chronic progression，resulting in poor prognosis and serious harm. Immune response is a key factor determining the clinical manifestation and outcome of hepatitis E. Normal immune response facilitates the clearance of virus and recovery from this disease，while excessive or disordered immune response can participate in severe and chronic progression of the disease，leading to disease progression. Through literature review，this article summarizes the immunological mechanisms of HEV related liver failure and chronic hepatitis E，including innate immune response and adaptive immune response，in order to provide theoretical basis and new ideas for early prediction，clinical prevention and treatment，and disease management.