Biliary cirrhosis is a chronic liver disease characterised by progressive destruction of the bile ducts, leading to cholestasis, fibrosis, and ultimately cirrhosis. It is clinically significant as it can result in liver failure and complications such as portal hypertension and hepatocellular carcinoma. A key association is primary biliary cholangitis, an autoimmune condition that often underlies biliary cirrhosis, particularly in middle-aged women.