Abstract Background: Sarcopenia should be considered as one of the main component of malnutrition in chronic liver diseases (CLD). Aim of Study: To assess the utility of ultrasound in detection of sarcopenia in children with chronic liver disease. Patients and Methods: The present study was conducted as a case control study included 77 children with CLD, who attended Pediatric Hepatology, Gastroenterology and Nutrition Department at our institution, and 62 age and sex matched healthy children as controls. Each child underwent: Full history taking, thorough clinical examination, laboratory investigations and assessment of sarcopenia. The primary outcome of the study was the utility of (ultrasound) US in detection of sarcopenia in children with CLD. Statistical analysis was performed using mixed methods. Results: There wasa statistically significant difference between diseased and healthy groups regarding echogenicity of biceps brachii, layer thickness, cross sectional area and echogenicity of rectus femoris (p-value=0.000, 0.018, 0.003 & 0.000). There was a statistically significant difference between diseased and healthy groups regarding total body fat range, total body fat mass, right limb fat range, right limb fat mass, left limb fat range and left limb fat mass (p-value= 0.048, 0.02, 0.013, 0.02, 0.007 & 0.024, respectively). Conclusion: There was a significant association between CLD in children and decreased muscle mass and strength especially in lower limb. US was able to detect early sarcopenic changes in diseased children while bioelectrical impedance analysis (BIA) which is a commonly used tool couldn't detect any muscle changes between healthy and diseased groups.