N-Acetyl Cysteine (NAC) is a precursor to glutathione, a major antioxidant involved in detoxification and cellular protection. Its use in liver-related conditions is primarily based on its established role in treating acetaminophen (paracetamol) overdose, where NAC replenishes glutathione stores and reduces liver damage. In the context of cirrhosis, which involves chronic liver injury and fibrosis, NAC has been investigated for its antioxidant and cytoprotective properties. Several small clinical studies and animal models have shown that NAC supplementation may improve some markers of oxidative stress and liver function in patients with cirrhosis, particularly in cases of acute-on-chronic liver failure. However, evidence is limited and inconsistent. Systematic reviews and guidelines do not currently endorse routine NAC use in chronic cirrhosis, as large, high-quality randomized controlled trials are lacking, and clinical outcomes such as survival have not been convincingly improved. The evidence base is thus modest (rated 2/5), with some scientific rationale and preliminary data, but insufficient to support widespread clinical use. NAC is not a traditional remedy for cirrhosis, nor is it a standard part of treatment protocols outside of specific acute toxic liver injuries. More robust clinical research is needed to establish its therapeutic role in cirrhosis management.