Background: Patients with liver disease have a unique pathophysiology that results in the need for a specialized evaluation before undergoing any surgical procedure. The objective of the present study was to assess different risk scores for high-risk cirrhotic patients. Patients and methods: We evaluated 115 cirrhotic patients in an Emergency Department, of the National Liver Institute, Menoufia University, using MELD, PALBI, ALBI, MELD Na scores. The studied cases had different presentations; 79 patients with strangulated umbilical hernia with bowel loops, 29 patients with intestinal ischemia from acute mesenteric vascular occlusion managed by surgical explorations, and 7 patients with secondary peritonitis from neglected spontaneous bacterial peritonitis.All participants signedan informed written consent. Results: MELD had a best cut off point 9.5, PALBI best cut off point -2.5, ALBI best cut off point -1.5, and MELD Na best cut off point 287.5. Sensitivities of MELD, PALBI, ALBI and MELD Na were 81.2%, 67%, 50%, and 44%, respectively. While specificities of MELD, PALBI, ALBI and MELD Na were 70%, 44.1%, 85.3%, and 77%, respectively. Conclusion: MELD, PALBI, and ALBI could be used in risk stratification in cirrhotic patients with emergent surgery.