Indications for liver biopsy technique were changed a lot over the recent few years. This was associated with dramatic revolution in viral diagnosis, viral vaccination and anti-viral therapy. This current work deals with a retrospective study of the prevalence of different hepatic lesions among liver biopsies received at Theodor Bilharz Research Institute within the periods from (1987 to 1989) compared to the period from (1996 to 1998) and from (2014 to 2016). It was found that the total number of liver biopsy specimens sent were not significantly changed during the three studied periods of time (p > 0.05). However, the number of liver biopsies was significantly and acutely decreased during the last two studied years (2015 and 2016) (p < 0.05). A well reported difference was also noticed in the pattern of biopsied liver lesions, being mostly bilharzial hepatitis in the eighties and nineties, while viral hepatitis came over during the new century with a marked reduction in the histopathological diagnosis of bilharziasis. Our study showed a steady increase in the histopathological diagnosis of chronic viral hepatitis between the different periods studied. On the contrary histopathological diagnosis of bilharzial liver disease was declining with time, being only about 1.6% at the period of time from 2014 to 2016. Diagnoses of autoimmune liver diseases, drug hepatitis, non-alcoholic fatty liver diseases (NAFD) and non-alcoholic steatohepatitis (NASH), were overcoming the diagnosis of bilharzial liver disease within recent years.

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