For several years, liver biopsy has been the established gold standard for evaluating the status of liver disease in patients with chronic hepatitis C. Although this procedure continues to be recommended, current practice is changing for 2 main reasons: firstly, treatment is more effective and, secondly, biochemical and serological tests provide a great deal of information on disease progression. Pathologists can increase the importance and utility of liver biopsy in chronic hepatitis C, providing information not only on the stage of fibrosis and necroinflammatory activity but also on the grade of steatosis and iron accumulation, which are implicated in disease progression. Moreover, these specialists can identify other diseases, such as steatohepatitis and hereditary hemochromatosis. Nevertheless, the use of serological tests will reduce the indications for liver biopsy.