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Hepatocyte apoptosis plays an important role in a wide range of chronic liver diseases such as: hepatitis C and B, as well as nonalcoholic steatohepatitis. Apoptosis is responsible for removal of damaged and degenerated cells, but also stimulates liver fibrosis, which can lead to cirrhosis. Aminotransferases activity currently used for routine diagnostics and management of liver disease may yield a significant number of false negative values. On the other hand liver biopsy recognized as a gold standard for evaluation hepatic diseases activity--is an invasive technique associated with potential complications and patients' sufferings. The novel biomarker helpful in identifying and monitoring activity of liver disease may be cytokeratin 18. Its fragment levels correlate with the magnitude of hepatocyte apoptosis and independently predict the presence of liver fibrosis and inflammation. This review will focus on potential use of cytokeratin 18 measurement in the diagnosis and management of chronic liver disorders.