The novel coronavirus disease 2019 (COVID-19) pandemic has impacted health care worldwide, with specific patient populations, such as those with diabetes, cardiovascular disease, and chronic lung disease, at higher risk of in-fection and others at higher risk of disease progression. Patients with decompensated cirrhosis fall into the lat-ter category and are a unique group that require specific treatment and management decisions because they can develop acute-on-chronic liver failure. In liver transplant recipients, the atypical immunity profile due to immuno-suppression protects against downstream inflammatory responses triggered by COVID-19. This exhaustive review discusses the outcomes associated with COVID-19 in pa-tients with advanced cirrhosis and in liver transplant recipi-ents. We focus on the immunopathogenesis of COVID-19, its correlation with the pathogenesis of advanced liver dis-ease, and the effect of immunosuppression in liver trans-plant recipients to provide insight into the outcomes of this unique patient population.