Hepatic damage caused by chronic exposure to arsenic has been frequently described. Here we report on 13 patients from West Bengal, India, who consumed large amounts of arsenic in drinking water. An epidemiological investigation of the study area showed evidence of chronic arsenical dermatosis and hepatomegaly in 62 (92.5%) of 67 members of families who drank contaminated water (arsenic level, 0.2-2 mg/l). In contrast, only six (6.25%) of 96 persons from the same area who drank safe water (arsenic level, <0.05 mg/l) had non-specific hepatomegaly, while none had skin lesions. Hepatomegaly occurred in all the 13 patients who were studied in detail, although five had splenomegaly. Biopsy of samples of liver from these patients revealed various degrees of fibrosis and expansion of the portal zone that resembled non-cirrhotic portal fibrosis (NCPF).