Histopathological examination of needle biopsies of the liver is a cornerstone in the diagnostic work-up on a patient with symptoms of chronic liver disease. It allows to confirm whether cirrhosis is present or not. In a considerable number of cases, this confirmation is definitive. In some cases, only a diagnostic level of suspicion is reached. In these cases, close collaboration between clinician and pathologist may increase the degree of diagnostic certainty. A reliable diagnosis of cirrhosis on liver biopsies requires careful consideration of differential diagnostic alternatives. Application of the full battery of histopathological techniques, including special stains, polarizing light and immunohistochemistry, allows to specify (or to help to specify) the aetiology in a substantial number of cases. The histopathologist should further look for information which bears on prognosis, and evaluate the stage, the activity and eventual complications by search of the corresponding histological changes.