Liver fibrosis is the common endpoint of chronic liver disease of variable aetiology. Liver injury induces excess deposition of extracellular matrix via inflammatory pathways, which in turn results in distortion of the vascular liver architecture. The two features combine to cause portal hypertension and reduced hepatocellular function. Diagnosis of liver fibrosis is made by liver biopsy, but non invasive tests like serological markers or elastographic methods are increasingly being recognized as useful tools in the diagnosis of fibrosis. Treatment options that exceed the treatment of the underlying liver disease are still largely experimental.