This systematic review examined the effect of Camellia sinensis (green tea) consumption and liver disease. Interventional and observational studies both in Western countries and in China and published between 1989 and December 2007 were retrieved from Medline, EMBASE, Chinese biomedicine Web databases and Chinese scientific journal databases using MeSH headings and assessed by two independent investigators according to established inclusion criteria. Ten studies (eight from China, one from Japan and the other from the USA) met the inclusion criteria assessing various outcomes such as liver cancer, cirrhosis and fatty liver disease. Four were RCTs, two were cohort studies, one a case-control study and three were cross-sectional studies. The heterogeneity in the study design, outcomes, confounders and amount of C. sinensis consumption precluded further meta-analysis. Nevertheless, eight studies showed a significant protective role of C. sinensis against various liver diseases as determined by RR/OR or P-value and among them, four studies showed a positive correlation between C. sinensis intake and attenuation of liver disease. Moreover, the other two studies also presented the protective tendency of C. sinensis against liver disease.