Chronic liver disease and cirrhosis are the 12th leading causes of death in the United States. There are many chronic liver diseases that lead to cirrhosis, such as viral hepatitis, autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, nonalcoholic steatohepatitis, alcohol, some toxins, and inborn errors of metabolism. Liver cancer is one of the fastest growing cancers in the world. Patients with end-stage liver disease (ESLD) present with malnutrition, muscle wasting, hyperlipidemia, fatigue, jaundice, and renal disease. Nurses need to be aware of the pathophysiology and etiologies of liver disease. Nurses need to explore and acknowledge their assumptions and biases about patients with liver disease and their families. Nurses play a pivotal role in advocating for advance care planning and early palliative care for patients with ESLD and their families. Patients with liver disease benefit from physical, psychosocial, and spiritual interventions offered through palliative care.