Background: Acute kidney injury (AKI) in cirrhosis, including hepatorenal syndrome (HRS), is a common and serious complication in cirrhotic patients, leading to significant morbidity and mortality. Objective: To predict value of serum and urinary NGAL as an early predictor of hepatorenal syndrome in cirrhotic patients. Patients and Methods: This study was a prospective clinical trial conducted at Kafr El Sheikh Liver Institution. The study included 60 participants with cirrhosis Child C on Child-Pugh score, each one was investigated for both Urinary and Plasma NGAL level. Results: Group I had urinary NGAL ranged from 12 - 120, with a mean value of 61.45 ± 36.17. While group II A, ranged from 211-493 with a mean value of 379 ± 72.825 and in group II B, ranged from 306-732 with a mean value of 438.05 ± 111.26. There was statistical difference between studied groups, p value <0.001. It was found that urinary NGAL is not only good predictor for early renal affection, but also it can differentiate between HRS and non HRS AKI due to the marked difference readings of its level in groups with renal impairment. Conclusion: Urinary NGAL shows noticeable differences between degree of elevation with different causes of AKI, so it somehow could be a trusted diagnostic tool to diagnose HRS.