Background: Histopathological examination is required in the evaluation of various liver diseases for both diagnosis and prognosis. Earlier blinded percutaneous liver biopsy was done commonly but now there are various studies suggesting that sonographic guided percutaneous liver biopsy could be more precise and safer. Our aim was to compare the safety and diagnostic utility of sonographic guided versus blind percutaneous liver biopsy. Methods: It was a retrospective single center study done between June 2003 and May 2007. Trucut Liver biopsy needle was used in all patients. Demographic, clinical and histological characteristics between the two groups were evaluated. Insufficient biopsy was defined as a sample with less than 6 portal spaces. We reviewed the type of complications and if hospitalization was required, or any mortality related to the procedure. Results: Out of 256 liver biopsies done in this period after excluding 16 patients we included 240 patients, 144 in Group A(60%, blind approach) and 96 in Group B (40%, sonographic guided approach). Mean age was 38±12.4 years and male: female ratio was 1.6:1. Biopsy was sufficient in 76% in Group A and 94% in Group B (p < 0.05). Minor complications occurred in 58% in Group A and 49% in Group B which was not significant. Major complications occurred in 2.8 % in Group A and 1.2% in Group B which was statistically significant. Mortality was 1.2% in Group A and 0.4% in Group B which was statistically significant. Conclusion: Our study suggest that sonographic guided percutaneous liver biopsy is superior in the diagnosis of liver diseases in all aspects when compared to blind approach as it is more safe, has more diagnostic utility with significantly less complications and mortality.