Background: Non-invasive detection of OV helps to decrease the necessity of endoscopy as a screening method. Aim of the study: To assess the usage of the measurement of noninflammatory gall bladder wall thickness (GBWT) as a noninvasive predictor of the presence and size of OV and also to compare it with platelet count to splenic diameter. Patients and Methods: the current study was a cross-sectional study performed on 100 cirrhotic patients who attended the hepatology and gastroenterology unit of the Internal Medicine department, Benha University Hospital, Egypt. Abdominal ultrasound was done to measure GBWT, upper gastrointestinal (GI) endoscopy was done in detection of OV, and blood tests were done. Patients were divided according to the presence of OV into two groups, Group I: included 50 cirrhotic patients with no OV (Non-OV group). Group II: included 50 cirrhotic patients with OV who were subdivided into two other subgroups, Group IIa: included 22 patients with small-sized O.V, and Group IIb: included 28 patients with large-sized O.V. Statistical analysis of the collected data was. Results: GBWT was significantly higher in OV patients compared to the Non-OV group (mean: 4.2 mm vs. 2.7 mm, p < 0.001), GBWT at cut-off ≥ 3.35 mm, had a sensitivity and specificity of 68% and 78% respectively Conclusion: GBWT could be used as a non-invasive method in the prediction of OV.