Cirrhosis of the liver is defined as the destruction of normal hepatic architecture through fibrosis and nodular regeneration. It is the eighth leading cause of death in the United States, and thus it is important for the primary care provider to be able to formulate a comprehensive, collaborative plan to provide high-quality care in a cost-effective and efficient manner. This chapter focuses on the comprehensive approach used by the primary care provider in caring for patients with cirrhosis. A definite diagnosis of cirrhosis and its etiology can usually be made by a liver biopsy demonstrating characteristic histological changes in conjunction with serological tests and viral markers. Patients with cirrhosis range from the asymptomatic, otherwise healthy patient to the patient presenting acutely with hepatic decompensation. Management of patients with decompensated cirrhosis involves symptomatic treatment of the complications of portal hypertension.