Chronic liver diseases (CLDs) constitute a major global health burden and represent one of the leading causes of liver-related morbidity and mortality. The principal etiologies include chronic viral hepatitis, metabolic dysfunction-associated steatotic liver disease (MASLD), alcohol-associated liver disease (ALD), autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, and genetic or metabolic disorders. Despite advances in laboratory diagnostics and imaging, histopathological evaluation remains the reference standard for assessing hepatic inflammation, fibrosis, architectural distortion, and disease progression. Liver biopsy provides valuable information regarding disease severity, prognosis, therapeutic response, and differential diagnosis. This review compares the characteristic histopathological features of major chronic liver diseases, highlights commonly used grading and staging systems, discusses the role of special stains and ancillary techniques, and reviews current diagnostic challenges. Published evidence demonstrates that integration of histopathology with clinical, biochemical, serological, radiological, and molecular findings provides the highest diagnostic accuracy. Emerging technologies including digital pathology, artificial intelligence, and quantitative image analysis are expected to improve diagnostic consistency and prognostic assessment.