Background: A common clinical condition, portal hypertension (PHT) is brought on by mesenchymal dysfunction in cirrhotic livers. Esophageal varices (EV), a dangerous complication, demand that patients be watched closely at all times. The zinc metallopeptidase angiotensin-converting enzyme (ACE) is located on the surface of endothelial and epithelial cells. It is an essential part of the renin-angiotensin system (RAS), which controls plasma volume and blood pressure. Objectives: The present study was designed to assess angiotensin-converting enzyme (ACE) levels in portal hypertension patients and study its association with presence of esophageal varices. Patients and methods: A total of 105 subjects, including 35 portal hypertension patients with esophageal varices, 35 portal hypertension patients without esophageal varices and 35 healthy controls were selected. ACE level was measured using enzyme-linked immunosorbent assay (ELISA) Results Serum ACE was significantly increased in PHTN with EV group versus PHTN without EV and healthy groups. A significant association was detected between ACE levels and the size of varices, as higher levels of ACE were found in patients with large varices (p=0.010).  In addition, a significant association was found between ACE and blood transfusion (p=0.012) and lower hemoglobin levels (P value < 0.001) in PHTN with EV group. A cutoff values of ≥ 44.15 ng/mL and ≥ 48.75 ng/mL could significantly discriminate PHT patients with EV from healthy controls and PHTN patients without esophageal varices respectively. Conclusion: It could be concluded that angiotensin-converting enzyme (ACE) could be a potential diagnostic marker for the presence of esophageal varices in portal hypertensive patients and a non- invasive marker for recognizing patients at risk of variceal rupture.