Hepatic encephalopathy (HE) affects numerous stakeholders from a clinical, psychosocial, and financial perspective. The multilayered impact of HE is threefold and affects different groups or, for the purpose of this commentary, villages. The first village mediates HE development, including genetics, microbiome, and disease severity. The second village consists of those affected by HE-related consequences, including the patient, caregivers, society, and medical system. The third village required to manage HE includes a multidisciplinary team of inpatient and outpatient providers, mental health experts, physical therapists, and dietary specialists. Understanding and integration of these three villages can encourage individualized care for patients and families affected by hepatic encephalopathy.