Abstract Acute Liver Failure (ALF) is a rapid and severe clinical syndrome defined by the onset of liver dysfunction and encephalopathy within eight weeks of symptoms in healthy individuals, or two weeks following jaundice in those with pre-existing disease. ALF arises from diverse etiologies. Nursing management is a cornerstone of ALF care, requiring intensive monitoring of neurological status, hemodynamic stability, and fluid-electrolyte balance. Specific interventions include managing cerebral edema, preventing hemorrhage through safety precautions, and providing nutritional support tailored to prevent ammonia accumulation. ALF presents a high-acuity challenge requiring specialized nursing care