The liver plays a key role during sepsis. These key roles include regulating metabolism, immune and inflammatory responses, and coagulation cascades, which are essential to the systemic response to sepsis. Sepsis is characterized by tissue and organ damage, which results in multiple organ dysfunction syndrome, including hepatic dysfunction, which significantly contributes to the severity of the disease. This review examines the inflammatory, hemodynamic, and metabolic alterations in sepsis and their effects on the liver. We outline the clinical and laboratory findings of sepsis-induced liver dysfunction. Finally, we discuss current and emerging therapies, as well as timely listing for liver transplantation.