Adipose tissue is now recognized as the largest endocrine organ in the body, secreting over 100 proteins termed adipokines that influence energy homeostasis, lipid physiology, inflammation, immune function and wound healing. Some of these proteins, such as TNFalpha, have important proinflammatory effects, but during hepatic injury are principally secreted at a local level within the liver. Their role in liver injury and fibrosis is beyond the scope of this review. However, circulating adipose-derived proteins such as leptin, adiponectin and resistin have important systemic effects, including the modulation of injury and fibrosis. The activities of these adipokines in the pathogenesis of liver injury and fibrosis will be the topic of this review.