Acute liver failure (ALF) is a rare but life-threatening condition requiring rapid recognition and decisive management. Early decisions around investigation, escalation, and referral can significantly impact outcomes. Despite advances in care, variation in practice and avoidable pitfalls remain common. In this podcast, we take a practical, case-based approach to the key “dos and don’ts” in ALF management, focusing on early diagnosis, initial stabilisation, appropriate investigations, and timely referral to specialist centres. What should clinicians prioritise, what should be avoided, and how can we optimise care in the critical early stages of acute liver failure?