Background: Liver cirrhosis is the most common cause of portal hypertension (PH). Esophageal varices (OV) are the most critical portosystemic shunts that develop secondary to portal hypertension, which is considered a main complication of liver cirrhosis. Objective: The purpose of this study was to compare the performance of serum marker – based indices and portal vein diameter assessed by ultrasound in patients of portal hypertension due to liver cirrhosis in prediction of large esophageal varices, graded on endoscopy. Patients and Methods: This cross-sectional study included sixty-six patients with liver cirrhosis who were admitted to Internal Medicine Department, Zagazig University Hospitals for screening the presence of esophageal varices and investigating and/or treating of the patients. The study was performed at a period from September 2019 to February 2020 Diagnosis of liver cirrhosis depended on typical clinical, laboratory, and ultrasound features. Results: There were statistically significant differences between large and small esophageal varices regarding AST, ALT, INR (higher in patients with large OV), platelet count (higher in patients with small OV). Conclusions: It could be concluded that Doppler ultrasonography is a non-invasive quantitative technique for the assessment of hemodynamic changes in patients with portal hypertension and appears to be useful in the identification of patients with liver cirrhosis at risk of upper gastrointestinal bleeding.