Introduction: Chronic liver disease (CLD) requires continuous multidisciplinary care, which is often limited by geographical and resource constraints. Telemedicine has emerged as a potential solution to improve disease monitoring and accessibility of hepatology care. This meta-analysis aimed to evaluate the clinical outcomes associated with telemedicine-based interventions in the management of CLD. Methods: A systematic search was conducted across PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to November 2025. Eligible randomized and observational studies comparing telemedicine interventions with standard in-person care among adults with CLD were included. Data were extracted following PRISMA guidelines, and pooled analyses were performed using a random-effects model. Primary outcomes included all-cause hospitalization and mortality; secondary outcomes included treatment adherence, patient satisfaction, and quality of life. Results: Fourteen studies encompassing 6,482 patients were included. Compared with standard care, telemedicine significantly reduced all-cause hospitalizations (pooled RR = 0.78; 95% CI 0.66–0.91; p = 0.002) and improved medication adherence (SMD = 0.42; 95% CI 0.21–0.63; p < 0.001). No significant difference was found in overall mortality (RR = 0.95; 95% CI 0.83–1.10). Subgroup analyses showed stronger effects in cirrhosis and post-transplant populations. Heterogeneity was moderate (I² = 47%), and publication bias was low. Conclusion: Telemedicine offers measurable benefits in managing chronic liver disease, particularly by reducing hospitalizations and enhancing adherence without compromising safety. Integrating tele-hepatology into standard care could substantially improve accessibility and efficiency of liver disease management worldwide. Keywords: telemedicine, chronic liver disease, cirrhosis, hepatology, meta-analysis