Following discussion on basics of hepatobiliary system, functions of the liver, manifestations of liver disease and diagnostic workup in suspected liver disorder, the Chapter presents an in-depth update on the Indian childhood cirrhosis. The disease that was peculiar to the Indian infants and children, usually 6 months to 4 years of age, has become rather infrequent now following the remedial measures in relation to copper (exclusion of brass and copper utensils for preparing infant foods in endemic areas) that turned out to be the most likely etiologic factor. From here, the text moves on to Reye’s syndrome, viral hepatitis, fulminant hepatitis, fulminant/acute hepatic failure (hepatic encephalopathy), chronic liver disease, chronic hepatitis, portal hypertension, neonatal cholestasis, drug-induced liver injury, liver abscess, and Wilson disease, ascites, etc. Finally, the salient features of the hot topic of orthotopic liver transplantation are outlined with particular reference to major indications, contraindications, and complications. “Rejection” of the allograft is a huge bottleneck in carrying out successful liver transplantation. In order to reduce the frequency of such a rejection, it is usual to give triple immunosuppression with prednisolone, azathioprine and cyclosporine postoperatively. In the event of rejection, pulse prednisolone therapy is the choice. Newer immunosuppressant’s like tacrolimus are employed in case of steroid resistance or cyclosporine-induced renal dysfunction.