Background: Trans Arterial Chemo-Embolization (TACE) is usually employed for unresectable hepatocellular carcinoma (HCC) and is largely considered to be palliative, but may be curative depending upon the stage of HCC. A common complication of TACE is decompensation of cirrhosis. The development of complications may depend upon various risk factors related to the liver disease, the patient and to the procedure itself. Objective: To identify the incidence and analyze the risk factors for of hepatic decompensation following TACE. Patients and methods: Retrospective descriptive study was conducted in Al-Rajhy Liver University Hospital, and Assiut University Hospitals. This study included 50 cases with HCC on top of liver cirrhosis, evaluation of liver function and proper staging of the tumour were done prior to TACE. Results: Basal Child and MELD score, initial tumor size and basal albumin level were statistically significantly (p < 0.005) correlated with decompensation following TACE. Conclusion: Proper selection of patients is essential for a better outcome and lower risk of hepatic decompensation after TACE. Serum albumin and tumour size were the independent predictors of decompensation.