The main goal of the anesthesiologist is to avoid making the hepatic disease (with perhaps its metabolic and CNS toxicity) worse and increasing the chance of renal failure, coma, and death. All anesthetics tested (general, narcotic-nitrous oxide, and regional) have caused transient effects on the liver. abnormalities in liver function test results. These abnormalities were magnified by upper intra-abdominal surgery and occurred regardless of preexisting liver disease. Patients whose preoperative liver function tests are abnormal will obviously have a higher effect on liver functions. The new inhalational anesthetics are safer on the liver when used with the modern mode of anesthesia as low flow anesthesia by which decreased the consumption, so decrease the bad effect on the liver .in this book there is the highlight on hepatitis c, modern inhalational anesthetics, and the low flow anesthesia."