The gold standard for the diagnosis of liver fibrosis is liver aspiration biopsy. Liver puncture biopsy is performed by skin puncture under the localization and guidance of ultrasound and CT. The puncture is performed to obtain a liver specimen generally about 10-25 mg, which is processed for pathological histology, immunohistochemistry and other staining, and liver tissue and cell morphology are observed under a microscope. With the continuous improvement of puncture instruments and operation methods, the one-second liver puncture method, which is now commonly used, is convenient and safe, with a high success rate and no obvious adverse effects. If patients are selected in strict accordance with the indications and contraindications of liver puncture, and adequate preparation and care are done before and after the operation, it will not aggravate the original liver lesions or aggravate the disease. In general, many patients with liver disease can be diagnosed after history taking and physical examination, or when supplemented with the necessary laboratory and imaging tests. However, some diseases cannot be diagnosed definitively and can only be concluded by liver aspiration biopsy and pathological examination, such as lymphoma, hepatocellular carcinoma, and tuberculosis. There are also some diseases that are difficult to diagnose and require liver biopsy combined with clinical symptoms to make a diagnosis, such as autoimmune hepatitis, chronic hepatitis, and primary biliary cirrhosis. Liver aspiration tests in patients with chronic hepatitis B can reveal whether the chronic hepatitis B is in an active stage and can infer the severity of the lesions. It can also provide a basis for the diagnosis of the etiology of each type of viral hepatitis, detect early, quiescent or still compensated cirrhosis, and judge the clinical efficacy. The accuracy of liver aspiration is significantly better than that of current imaging tests, and it is the internationally recognized “gold standard” for determining the severity of liver fibrosis in particular.