Chronic liver disease is a debilitating condition that can lead to end-stage liver disease (ESLD). The most common causes of liver disease include infection and alcohol abuse. When patients present with liver disease, a thorough assessment should be undertaken, including identification of risk factors. For patients who have signs of ESLD, valid prognostic tools such as the Model for End-Stage Liver Disease or the Child–Turcotte–Pugh should be used to estimate terminality. Referral to hospice care should occur when it is consistent with the patient's goals of care. This chapter helps the nurse to identify key assessment findings indicative of liver disease, explain end-of-life considerations for patients who have liver failure, and discuss end-of-care options for patients who have liver failure. Hospice care should be initiated when the patient's condition is consistent with admission criteria and hospice admission is consistent with the patient's goals of care.