In patients with cirrhosis and chronic liver disease, acute-on-chronic liver failure is emerging as a major cause of mortality. That’s why an update on precipitating factors and essential management strategies is the basis of Dr. Peter Buch’s discussion with Dr. Jasmohan Bajaj, Professor of Medicine at the Richmond VA Medical Center and lead author of the article “Acute-on-Chronic Liver Failure Clinical Guidelines,” which was published in the American Journal of Gastroenterology in February 2022.