Liver disease represents a major and under-recognised public health challenge across Africa, driven by a complex interplay of viral hepatitis, rising metabolic dysfunction-associated steatotic liver disease, and a high burden of hepatocellular carcinoma (HCC). Despite this, awareness, surveillance, and access to care remain limited. In this podcast, we explore the evolving epidemiology of liver disease across the continent, highlighting key drivers, regional variations, and gaps in diagnosis and treatment. Why does the burden remain so under-recognised, and what are the priorities for prevention, early detection, and equitable care in Africa?