The expert panel of American Association for the Study of Liver Diseases published Practice guidance on acute-on-chronic liver failure and the management of critically ill patients with cirrhosis on November 9, 2023 in Hepatology. This practice guidance elaborates on the definition of acute-on-chronic liver failure, prediction models, and the management of liver cirrhosis comorbid with acute-on-chronic liver failure and organ failure in critically ill patients, and this article gives an excerpt of the key points in the practice guidance.