Pregnant women can have hepatic impairment as a consequence of a gestational liver disorder, e.g. severe pre-eclampsia, acute fatty liver of pregnancy or intrahepatic cholestasis of pregnancy. They may also have a new presentation of a liver disease. Those with chronic liver disorders will benefit from pre-pregnancy counselling and advice on the risks and benefits of treatments and interventions. This lecture will consider the latest research and guidance on managing gestational and pre-existing liver disorders. It will consider the implications of changing trends in the epidemiology of NAFLD and cirrhosis and how this may impact management of pregnant women and the utility of new treatments that are being developed for treatment of people with hepatic disorders.