This is a procedure where a tiny core of liver tissue, usually < 1 mm in diameter and 1 - 2 cm in length, is retrieved for microscopic examination, through a small needle puncture of the liver. Such an examination is able to confirm the diagnosis of certain liver diseases and assess the severity. A precise microscopic diagnosis is sometimes necessary for the doctors to make major treatment decisions and to predict the long-term outcome of a patient’s condition. The liver biopsy may be performed by two main methods: The liver may be punctured directly by a needle through the overlying skin at the side of the right lower ribcage, or sometimes, at the central part of the upper abdomen. Depending on the indication of individual patient’s condition, this can be done with or without the aid of a simultaneous liver scan. Alternatively, a long line with a sheathed needle at its tip can be floated down the vein to the liver, through the right jugular vein at the neck. On reaching the liver, the needle is then unsheathed for liver tissue retrieval. The choice of procedure depends on individual patient’s condition. The former method is more commonly used, and the latter is reserved for patients who have bleeding tendencies. While a proportion of patients may experience some local discomfort or mild pain at the puncture site or pain over the left shoulder after the procedure, this usually does not last for more than a day. The main risk of such procedure is that of bleeding, which ranges from a mild complication (0.1 – 0.6% risk) to serious or fatal bleed (0.04 – 0.4% risk). Most patients will require an overnight stay in the hospital after the procedure for observation of bleeding. They can usually return home the next day.