An estimated 50 million dengue infections occur annually across approximately 100 tropical and subtropical countries. There is extensive clinical, biochemical, histological, radiographic, and experimental evidence of liver involvement in dengue virus infections. Transaminase elevations are commonly seen. Most cases of dengueassociated liver disease are mild. Severe acute hepatitis due to the dengue virus is uncommon. Proposed causes of liver dysfunction in dengue virus infections include a direct viral effect on hepatocytes and a dysregulated host immune response against the virus. Several avenues of future research are suggested.