The Acute-on-Chronic Liver Failure (ACLF) Special Interest Group presents current clinical and research gaps pertaining to the study and care of patients with ACLF. The introductory presentation prompts further discussion on 4 distinct topics focused on: (1) outstanding care gaps in critically ill patients with ACLF; (2) the role of novel statistical methods in ACLF diagnosis and prognostication; (3) designing clinical studies in ACLF; and (4) pathways to therapeutic advancements in ACLF. The session concludes with a panel discussion.