Background: Chemotherapy-induced liver injury (CALI) is well documented. However, it is not clear whether CALI is progressive or reversible. This study asked whether there was any difference in total liver injury score in patients who had had chemotherapy and repeat liver resections (LR) for colorectal metastases (CRM). Methods: Of 758 patients undergoing LR for CRM in a single centre between January 2010 and December 2015, 431 had preoperative chemotherapy, 68 of whom had a second LR, after a median (range) interval of 11 (1-45) months. The total histological liver injury scores for parenchymal steatosis, sinusoidal dilation and lobular inflammation were calculated and compared between the first and second LR. Results: The total liver injury score improved in 29% of cases, stayed static in 31% and deteriorated in 40%. 47 patients did not receive chemotherapy between the first and second LR and their liver injury scores improved in 30%, were unchanged in 34% and deteriorated in 36%, compared to 21 patients who received further chemotherapy, whose scores improved in 28%, were unchanged in 24% but worse in 48%. Of the 37 patients who had an initial major LR, 40% had significantly improved scores on the second LR, compared 16% of patients with a minor LR (n=31) (p=0.034). Conclusion: This study shows that CALI can progress or improve over time, depending on the magnitude of the initial LR and whether more chemotherapy is given.