Purpose:   To distinguish  the  alarming   from the  non-alarming signs  during  immediate postoperative  Doppler ultrasonography (US) follow up for liver transplantation cases. Patients  and methods:  From March 2012 to June 2013, 36 patients of post living related donor liver transplantation where followed up in the first month after liver transplantation and the US and Doppler US changes were recorded together with their laboratory data. When there were alarming Doppler US signs CT angiography was done to confirm vascular complications. Results:  5 cases  (13.8%)  presented  with hyperechoic  segments  due to segmental  venous congestion,  12 cases  {33.3%) showed  raw  surface  collection,  15  cases  (41.6%)  presented with free peritoneal fluid and 18 cases (50%)   had right pleural effusion. One patient (2.7%) presented with occluded hepatic artery and thrombectomy was done. 30 cases {83.3%) showed increased  portal  vein velocity  The mortality  was 8.3% seen in 3 cases, two of them  (5.5%) suffered from  7th day syndrome presented with abrupt sharp decrease in portal flow and one case (2.7%) had a small graft size and presented with marked slowliness of the portal flow on Doppler study and a venous infarct on CT Conclusion: The early monitoring  of graft hemodynamic  changes by Doppler sonography is of great importance  as  most of these  changes  revert to normal  in the first postoperative week, however sharp decrease in arterial or portal flow indicates  underlying grave vascular complications, some of them are correctable.