Background: Cirrhosis represents the final common pathological outcome for the majority of chronic liver diseases. Most patients with cirrhosis die from one or more clinical complications including ascites, hepatic encephalopathy and variceal hemorrhage. Objective: The aim of the study was to explore the relationship between serum kallistatin and clinical evidence of cirrhosis and to determine if serum kallistatin levels could be used as a diagnostic indicator of hepatic health status especially human liver cirrhosis. Patients and methods: The present study included 70 patients with liver cirrhosis and 25 healthy volunteers served as controls. Cirrhotic patients were subdivided into groups A, B and C according to Child score. Results: The results in the current study revealed that there was highly significant decrease of kallistatin level in liver cirrhosis patients compared to control group. The level of kallistatin was significantly decreased in decompensated patients more than compensated patients. These findings pointed to the value of kallistatin as a new biomarker for diagnosis of liver cirrhosis. Conclusion: Our findings support that kallistatin may be an efficient biomarker in early detection of liver cirrhosis. Also combination of kallistatin with Fib4 score could improve the sensitivity and specificity for chronic liver disease.