Minimal encephalopathy (MHE) is the leading cause of cognitive dysfunction in patients with liver cirrhosis who are characterized by abnormal responses to psychometric and/or neurophysiological tests without clinically abnormal feature. Patients with MHE have poor-health-related quality of life (HRQOL) and thus have difficulty to have job, resulting in poor socio-economic life. Moreover, the patients with MHE meet frequent life-threatening risk due to cognitive dysfunction throughout their life. In particular, recent reports have demonstrated that patients with MHE are unfit to drive in 52% to 100% of cases. Although there is still debate over whether active treatment for patients with MHE is needed or not in terms of cost-effectiveness, recent studies have suggested that active treatment for MHE could improve HRQOL, enhance driving ability, and eventually may prevent the development of overt hepatic encephalopathy.