The mutual relationship between iron and liver disease is highlighted by the fact that too much iron can cause liver disease, while hepatic iron overload can also result from acute or chronic liver diseases. As the principal storage site for iron, hepatic iron concentration is a reliable surrogate marker for total body iron in iron overload conditions. Assessment of hepatic iron is therefore important for the initiation and monitoring of treatment of iron overload by therapeutic phlebotomies or iron chelators. The present chapter reviews how the liver controls iron homeostasis, and discusses how liver iron can be assessed before primary and secondary liver diseases with iron overload.