For many people, jaundice will occur as part of an episode of acute, self-limiting, viral hepatitis but in the context of chronic hepatic disease or malignancy, the development of jaundice or ascites is usually an ominous indicator of advanced disease. In two reported studies of individuals admitted to hospital with jaundice, 24% and 42% of patients with malignancy and 23% with cirrhosis died during their first admission. The necessity of a willingness to adopt a ‘palliative approach’ to the care of such individuals is obvious. This chapter discusses three features of liver impairment that may be encountered in those for whom palliative care is appropriate but the review of ascites concentrates on causes other than cirrhosis and portal hypertension.