Background <p>Previous studies have indicated that certain bile acids (BAs) were associated with the occurrence and development of liver cancer. However, a comprehensive analysis of serum bile acid (BA) expression patterns and dysregulation in liver cancer remained unexplored.</p> Aim of review <p>This meta-analysis aimed to evaluate serum BA profiles comprehensively and determine the association between specific BA molecular species and liver cancer.</p> Key scientific concepts of review <p>BAs, key molecules in metabolism and signaling, have been increasingly recognized for their role in liver cancer pathogenesis. While prior studies have explored individual BAs, a systematic analysis of their dysregulation in liver cancer has remained unaddressed. This meta-analysis analyzed data from 14 original studies with a total of 2994 participants (1686 liver cancer cases and 1308 controls) and revealed significant alterations in both primary and secondary BAs, along with disrupted BA ratios in liver cancer patients. These findings underscored the profound metabolic dysregulation in liver cancer and presented critical insights that might aid in disease diagnosis and management.</p>