Background: Low platelets count (PLT), high spleen volume on ultrasonography, and a high Child-Pugh score are among the most reported recent cirrhosis assessment characteristics. Objective: This study aimed to evaluate the utilization of platelet count combined with magnetic resonance imaging to measure spleen volume (SV) and right liver volume to identify cirrhosis and esophageal varices (EV). Patients and methods: A total of 50 cirrhotic patients diagnosed by abdominal ultrasound and/or MRI. They were referred from the General Medicine and Tropical Departments of Zagazig University Hospitals. We studied platelet count combined with magnetic resonance imaging to measure spleen volume and right liver volume for detection of severity of cirrhosis and esophageal varices. Results: The best cutoff value of SI/platelet count in prediction of cirrhosis and child C were ≥ 3.24 and ≥ 6.625 respectively. SV/platelet count and SI/platelet count differed significantly among groups. RVPS differed significantly between groups and was significantly lower in OV. The best cutoff value of SI/platelet count and SV/platelet count in prediction of OV were ≥ 5.05 and ≥ 3.24 respectively. RVPS differed significantly between studied groups as it was significantly lower in OV. Conclusion: With the advancement of the Child-Pugh class, the ratio of SV/PLT and SI/PLT increased, as the Child-Pugh class progressed PLT and RVPS diminished. RVPS can be used as a new combination parameter to determine the occurrence of cirrhosis and discriminate between the CPS classes.