Chronic hepatitis E (CHE) infection in organ transplant recipients has been exclusively related to genotype 3 hepatitis E virus (HEV) infection, and mainly prevalent in Western countries.1 However, it remains unclear whether other genotypes of HEV can also result in chronic hepatitis. Herein, we report the first case of genotype 4 (G4) HEV caused chronic infection and the clinical outcome in organ transplant recipient in China, warranting the devotion of future research to CHE in organ transplant recipients, where G4 HEV is prevalent.