This chapter discusses neurological manifestations of chronic liver disease. Chronic liver disease (CHD) encompasses a broad group of indolent infectious, metabolic, and structural hepatic disorders. These include chronic persistent hepatitis, chronic active hepatitis, hepatic cirrhosis, hepatic dysfunction in Wilson’s disease and that in hemochromatosis. Wilson’s disease is a distinct nosological entity wherein neurological and hepatic derangements occur in variable combinations due to an inherent anomaly of copper metabolism. The neurological manifestations of chronic liver disease were first reported in English medical literature by hepatologists. Myelopathy in chronic liver disease is characterized by the occurrence of a progressive spastic paraparesis without sensory signs or a sensory level. This chapter covers the pathological changes in chronic non-wilsonian hepatocerebral degeneration, investigations, therapy, and extrahepatic manifestations of hepatitis E infection.