In the Western World alcohol is the major cause of liver disease, whilst elsewhere the hepatitis B virus is still a significant factor. The longer term clinical consequences of hepatitis C are now being increasingly recognized. Health education and the improvement of social conditions should help stop the spread of viral infections. Imaging techniques now enable the liver and biliary tree to be visualized with precision resulting in earlier diagnosis and the advent of laparoscopic surgery avoids the necessity of open surgery for biliary tract disease. Results of liver transplantation continue to improve and transplantation can be of value in the treatment of both acute and chronic liver failure.