Different approaches to liver-specific medicines, particularly silymarin, which exist in russian and foreign hepatology leads to formation of some difficulties in their medical usage. There is a necessity to discuss classification and terminology aspects and to study study present evidence about silymarin medicines content, pharmacokinetic and mechanisms of action, clinical efficacy and safety in patients with hepatic disorders. We had performed search in medical databases and analysed articles about silymarin. The results of clinical trials and systematic reviews of silymarin use show high efficacy of the drug in patients with amanitine, drugs, and other toxic injuries of liver, viral hepatitis, NASH. In patients with carcinoma and primarily biliary cirrhosis efficacy of silymarin is ambiguous.