Background: Improvement of patient-centered outcomes through standardization of ultrasound reporting in patients at high risk of developing Hepatocellular Carcinoma (HCC). Objective: To assess the role of US-LI-RADS in the detection of HCC in high-risk patients. Patients and Methods: Fifty patients of both sexes referred from Tropical and Internal Medicine Departments with cirrhosis due to chronic viral hepatitis (C&B) with a mean age of 58 years were included in this comprehensive study, at the Radiodiagnosis Department, Faculty of Medicine, Zagazig University Hospital. All patients were subjected to conventional B-mode ultrasound. Results: Out of the 50 cirrhotic patients, 13 patients (26%) had positive findings by the US. Using US-3 as a positive finding had a high specificity and negative predictive value (100 percent). Instead of being high, the sensitivity and positive predictive value (PPV) were poor when a positive observation was classified as US-3 (43.3 percent). Conclusion:  It was found that the LI-RADS US-3 category had a high specificity for hepatocellular carcinoma diagnoses, however, it had a low sensitivity.