Background: According to current guidelines, all patients with cirrhosis should have a screening endoscopy performed at the time of diagnosis in order to identify those who would benefit from primary prophylaxis and have varices that put them at high risk of bleeding. By identifying patients at highest risk for esophageal varices noninvasively, invasive study would only be necessary for those most likely to benefit. Objective: Our study's objective was to ascertain the predictive efficacy of noninvasive indicators (Right lobe diameter/serum albumin ratio) in predict esophageal varices. Patients and Methods: This is a cross-sectional study carried on 100 patients collected from the Hepatology Outpatient Clinics and from Hepatology and Gastroenterology Unit, Internal Medicine Department at Ain Shams University Hospital over 6-months period. All patients were divided into 3 groups: 30 patients with Child-Pugh A, 30 patients with Child-Pugh B, and 40 patients with Child-Pugh C. Results: Our study showed by regarding platelet count, INR, serum albumin, liver size, liver size/serum albumin ratio that there was a significant difference among esophageal varices grades. Liver size/serum albumin ratio had non-significant diagnostic performance in differentiating esophageal varices grade-I from grade-0, and had significant moderate diagnostic performance in differentiating other esophageal varices grades from each other. Liver size/serum albumin ratio cutoff points had high specificity and PPV but low sensitivity and NPV in differentiating grade-I from grade-0, and had high sensitivity and NPV but moderate specificity and PPV in differentiating other grades from each other. Conclusion: Our study stresses on the use of some of the non-invasive parameters in predicting the grade of esophageal varices in cirrhotic patients without submitting them to the invasive, time consuming and expensive procedure of endoscopy.