Background: Patients with liver disease have a unique pathophysiology that results in the need for a specialized evaluation before undergoing any surgical procedure. The objective of the present study was to assess different risk scores for highrisk cirrhotic patients. Patients and methods: We evaluated 115 cirrhotic patients in an Emergency Department, of the National Liver Institute, Menoufia University, using MELD, PALBI, ALBI, MELD Na scores. The studied cases had different presentations; 79 patients with strangulated umbilical hernia with bowel loops, 29 patients with intestinal ischemia from acute mesenteric vascular occlusion managed by surgical explorations, and 7 patients with secondary peritonitis from neglected spontaneous bacterial peritonitis. All participants signed an informed written consent.