Liver diseases, such as acute injury, chronic fibrosis and hepatocellular carcinoma (HCC), represent a major global health challenge with limited treatment options. The liver has a natural ability to regenerate, but it is impaired in chronic diseases and leads to poor results. Amphiregulin (AREG), a ligand of the epidermal growth factor receptor (EGFR), promotes protective regeneration in acute liver injury. However, in chronic conditions, AREG controls harmful processes. The review examines the dual and dynamic roles of AREG in a spectrum of liver diseases, including expression patterns, downstream molecular pathways and signaling networks. These pathways determine the transition of AREG from regeneration to fibrosis and carcinogenesis. The findings provide theoretical foundations and potential intervention strategies for targeting the AREG-EGFR axis in the treatment of liver diseases.