Iron accumulation in the liver is frequently observed in hepatic diseases whatever their etiologies. In the majority of cases, there is no true overload, and iron accumulation corresponds to deposits in macrophages secondary to iron release from damaged hepatocytes. More rarely, namely in severe cirrhosis, there is a true overload, which is probably related to iron intestinal hyperabsorption. In such case, the site of iron excess is hepatocytic. Except for hemochromatosis, mutations of HFE gene do not play a major role in iron overload. In chronic liver diseases, iron overload could favor the development of hepatocellular carcinoma, even in the absence of cirrhosis.