Hepatic encephalopathy in pregnancy may be related to a wide variety of acute and chronic liver diseases, including acute viral hepatitis, acute fatty liver of pregnancy, pre-eclampsia-related liver injury, etc. Of these, hepatitis E virus infection is a particularly important cause in those developing countries where this infection is endemic. Etiological diagnosis can be made based on epidemiologic, clinical and laboratory findings. Treatment is usually similar to that of hepatic encephalopathy in the absence of pregnancy. Patients with acute fatty liver of pregnancy and pre-eclampsia-related liver injury may benefit from termination of pregnancy; the role of this treatment modality among patients with viral hepatitis has not been studied.