In our study, real-time ultrasound guided liver biopsies were performed by senior residents in Gastroenterology and Hepatology (in an outpatient setting). We found similar results regarding the safety even in a scenario of physicians in training. In addition, the reasons for PLB have undergone a transformation over the years. It was possible to notice a remarkable drop in the amount of hepatitis C-related procedures and a progressive increase in the number of biopsies due to metabolic dysfunction-associated fatty liver disease (MAFLD), known as hepatic steatosis.