Background/Aim: Histopathological examination for liver biopsy combined with clinicaldata can suggest a cause in most cases of liver diseases. Our aim from this work is to studythe indications and spectrum of histopathological findings in liver biopsies obtained fromEgyptian infants and children with liver diseases.Methods: A descriptive study of all liver biopsy reports of infants and children who wereindicated, fit and consented to do a liver biopsy. The cases attended the hepatology outpatientclinic at Cairo University pediatric hospital over five years in the period from 2007 to 2011.Results: In the current study the total number of liver biopsy reports reviewed was 1077. Outof the total number of the liver biopsies data available, there were 20 reports withundiagnosed tiny specimens (1.9%). In the remaining 1057 report; the mean age of cases was2.96 ± 4.1 years ranging from 1 month to 18 years. There were 56.5% cases aged 1-12months, 80% clinically presented with cholestasis &11% with hepatomegaly and the mainhistopathological diagnosis in this group was neonatal hepatitis in 37.2% and biliary atresia in33.7%. Cases aged 1-6 years were 25.7%, clinically presented with hepatomegaly in 41.9% &HSM in 27.6% and the main final diagnosis was chronic hepatitis in 32.7% and glycogenstorage disease in 22.8%. 14.7% were cases aged 6-13 years, clinically presented with HCVinfection in 30.1% & hepatomegaly in 16% and the main histopathological diagnosis was56.4% chronic hepatitis and 5% cirrhosis. 3% were cases aged 13-18 years, 56.3% clinicallypresented with HCV infection & 6.6% with HBV infection and the main diagnosis waschronic hepatitis in 71.9%.Conclusion: The commonest clinical presentation and indication of liver biopsy in Egyptianchildren with liver diseases was cholestasis and hepatomegaly and the commonest diagnosiswas neonatal hepatitis, biliary atresia and chronic hepatitis.