HEPASCORE has been developed to optimize the application of objective criteria for qualitative and quantitative assessment of liver function. Early recognition of abnormal liver states is performed according to a sequential approach, based at first on clinical rules using data from history and physical examination, then confirming or denying the hypothesis by means of selected laboratory tests. Once an abnormal condition is defined, clinical severity can be evaluated using suitable scores. In addition, selected sets of biochemical tests can be used to score one or more functional aspects. HEPASCORE has been successfully applied to exclude liver abnormalities in subjects at risk, to follow-up liver patients, to predict the natural outcomes of severe liver diseases, to foresee the adverse effects of drugs undergoing firstpass liver extraction and the side effects of invasive procedures.