Cirrhosis is a serious hepatic disease that occurs worldwide and is caused by progressive fibrosis in the liver. Free radicals are the major cause of reactive oxygen species (ROS) generation, which affects the balance of the liver metabolism. Piper crocatum, commonly called red betel, is widely used in ethnomedicine because it has biological capabilities, including antioxidant and anti-inflammatory properties. The present study was undertaken to examine the possibility of hepaprotective activity of red betel extract on acetaminophen (APAP)-induced HepG2 cells as the cirrhosis in vitro model. Assessment of red betel extract (RBE) was performed using the colorimetric method for the quantification of LDH, AST, and ALT. As preliminary study, a cytotoxicity assay was performed at various RBE concentrations (100.00; 50.00; 25.00; 12.50; 6.25; 3.13 μg/ml) using an MTS assay to decide the safe concentration based on cell viability. The RBE treatment did not affect cell viability, even at a high concentration (100 µg/ml, p > 0.05). RBE at concentrations 25 and 100 µg/ml successfully reduced LDH, AST, and ALT activities in the hepatotoxic model in a dose-dependent manner. In the APAP-induced hepatotoxicity model, RBE positively indicated a hepatoprotective effect and cell amelioration by a decrease in hepatotoxic markers.