Aim of the study <p>Based on secondary data the present study aims to investigate and explain regional differences in the distribution of liver fibrosis and cirrhosis. On this basis, region-specific prevention programs can then be designed.</p> Methods <p>Data on the frequencies of inpatient and outpatient diagnoses and mortality of liver cirrhosis, alcoholic liver disease and chronic hepatitis at the level of districts and independent cities (<i>n</i> = 413) were used. The secondary data are supplemented firstly by data from the National Consumption Study&#xa0;II on alcohol consumption per day and the frequencies of outpatient diagnosis of alcohol abuse disorders and secondly, by socioeconomic variables and the density of outpatient neurologists as an indicator of access to the healthcare system. The respective variables were combined to form standardized sum indices for alcoholic liver disease, liver fibrosis and cirrhosis and chronic viral hepatitis and checked for autocorrelation according to Moran’s&#xa0;I. In order to determine the explanatory contribution of the individual variables two spatial lag and spatial error models were then calculated.</p> Results <p>Clear regional differences in the distribution of liver cirrhosis could be shown. Using the relevant spatial error model 60% of the regional differences in the distribution of liver cirrhosis were explained by the distribution pattern of alcoholic liver disease, chronic viral hepatitis, daily alcohol consumption and four socioeconomic variables.</p> Conclusion <p>Regional differences in the distribution of liver fibrosis and cirrhosis can be explained to a&#xa0;considerable extent by secondary data on etiologically significant pre-existing diseases and lifestyle data as well as socioeconomic determinants. Other underlying factors that go beyond the etiology of alcohol abuse and viral hepatitis and the other determinants considered are to be assumed.</p>