Introduction: Liver biopsy is an important diagnostic tool that assists determination of specific diagnoses and directs therapeutic decisions in patients with acute and chronic liver diseases. It can also be used to estimate the degree of liver damage to grade and stage hepatitis B and C, and to determine the best treatment for the damage or disease. Material and Method: A two year prospective study was conducted on 78 liver biopsies in the Department of Pathology, M.S. Ramaiah Medical College and Hospital from January 2018 to January 2020. The sections were examined and the histopathological findings were recorded. Immunohistochemistry (IHC) was performed by using markerssuch as CK7, CK20, CDX2, CEA, Hep par 1, TTF-1, synaptophysin, chromogranin and AFP for increased diagnostic accuracy. Results: In this study, age ranged from 3 months to 80 years. Mean age was 42.5 years. Out of 78 cases, 51 cases were males, 27 were females. Liver biopsy revealed that chronic hepatitis and metastasis were the commonest findings constituting 14.1% each. Hepatocellular carcinoma (HCC) and cirrhosis constituted 11.53% and 10.25% of total cases, respectively. Conclusion: Liver biopsy continues to play an important role in modern clinical practice and remains the gold standard for the diagnosis of majority of the hepatic diseases. Histopathological examination of liver biopsy specimen is an essential, safe and reliable tool for the diagnosis, accurate assessment of severity and follow up of the various hepatic lesions.

Keywords: Histomorphological analysis; Hepatic lesions; Liver biopsy.