For patients with chronic liver disease, “cirrhosis” is not an unfamiliar concept, but “liver fibrosis” may not be well understood. Liver fibrosis is not an independent disease, but a pathological process of abnormal proliferation of fibrous connective tissue in the liver when liver cells are stimulated by necrosis and inflammation. As a simple example, when we have a break or wound in the skin somewhere, it will leave a large or small scar when the wound grows back. This scar is formed by fibrous tissue, and the process of scarring is called fibrosis. The process of liver fibrosis is similar to the process of scarring, except that the site of scarring is in the liver. When the liver has cellular inflammation for various reasons, the necrotic liver cells will be removed by the body, and when the liver repairs itself, there will be continuous proliferation of fibrous tissue, which will eventually destroy the structure of normal liver tissue and form many nodules surrounded by fibrous tissue, and the texture of the liver will become hard, and cirrhosis will be formed. In other words, liver fibrosis is actually the liver’s repair response to tissue damage caused by various etiologies, which is a long and complex clinicopathological process. If left untreated, most patients will progress to cirrhosis, which will lead to chronic liver failure and portal hypertension. Therefore, it can also be said that the relationship between “liver fibrosis” and “cirrhosis” is a relationship from quantitative to qualitative change. For patients with chronic liver disease, when chronic inflammation of the liver persists, it is often accompanied by liver fibrosis. Chronic hepatitis B is still the most common cause of liver fibrosis in China, and chronic hepatitis C is also not uncommon. Both types of hepatitis are caused by hepatitis virus replication, which leads to dysfunction of the body’s immune system, causing immune lymphocytes to “accidentally” injure liver cells when removing the virus, resulting in inflammation in the liver, which induces the proliferation of fibrous tissue, resulting in liver fibrosis. With the improvement of people’s living standard, the incidence of alcoholic liver disease and non-alcoholic liver disease in China is increasing, both of which can be manifested as excessive deposition of fat in liver cells, which can lead to steatohepatitis in severe cases. Others, such as drug-related liver disease, metabolic liver disease, autoimmune liver disease or schistosomiasis, etc., with the increasing level of understanding of these chronic liver diseases and the continuous improvement of diagnostic techniques, liver fibrosis due to the above-mentioned etiologies will also be increasingly detected in clinical practice. The degree of fibrosis is sometimes not necessarily proportional to the degree of disease or the duration of the disease, because the physical condition and the onset of the disease are different for each patient. Hepatocellular carcinoma is the most aggressive of all liver diseases and is often associated with cirrhosis. Many clinical studies have shown that there is a strong association from hepatitis to cirrhosis to liver cancer. Since the continuous progression of liver fibrosis can eventually lead to cirrhosis and even life-threatening liver failure and liver cancer, early diagnosis and treatment is an important condition for the treatment of liver fibrosis, as in the case of most diseases, to help reduce, reverse or even cure liver fibrosis. Accurate determination of the degree of liver fibrosis is a key component in understanding the prognosis of chronic liver disease, evaluating the efficacy of antifibrosis and determining the endpoint of treatment. However, because liver fibrosis has no specific clinical manifestations, its diagnosis is currently based mainly on liver histopathology, imaging (ultrasound, CT, etc.) and serological examinations. Among them, histopathological examination of liver biopsy is still the “gold standard” for the diagnosis of liver fibrosis, especially for the staging of liver fibrosis. In addition, the Fibroscan, which has been used in the medical market in recent years, has the advantages of non-invasive, rapid, simple and objective quantification, and can be used for instantaneous liver elastometry in patients with chronic hepatitis, and has become a new method for clinical diagnosis of liver fibrosis. More than 10 years ago, liver fibrosis was considered to be irreversible. However, over the years, through the unremitting efforts of researchers, it has been proven that liver fibrosis and even early cirrhosis can be reversed. In patients with cirrhosis, anti-fibrotic treatment can slow down the progression of the disease and prolong life. Even after liver cancer surgery, complicating cirrhosis needs to be treated by anti-fibrosis. For the treatment of liver fibrosis, there are no safe and effective western drugs. Chinese and Western liver disease researchers in China have diligently tapped the treasures of Chinese medicine in the past 20 years, and have developed some effective herbal compound preparations for the prevention and treatment of liver fibrosis, reflecting the advantages of Chinese medicine in anti-liver fibrosis. Treatments targeting the causes of liver disease also play an important role in delaying or reducing liver fibrosis, such as antiviral treatment for chronic viral hepatitis, treatment to reduce iron and copper intake, as well as alcohol cessation, exercise and lifestyle changes can also reduce the degree of liver fibrosis. At the same time, researchers continue to actively explore clinically applicable anti-fibrotic drugs. In conclusion, identifying the cause of liver fibrosis and providing effective etiologic treatment is essential to stop or even reverse liver fibrosis, while early and accurate diagnosis and staging of liver fibrosis is a necessary prerequisite for determining the prognosis of chronic liver disease and evaluating the efficacy of anti-fibrotic therapy. With the in-depth understanding of the mechanism of liver fibrosis, more effective anti-fibrotic drugs and biologics will be available from the laboratory to the clinic. The goal of overcoming liver fibrosis will eventually be achieved.