The liver plays several key roles in blood coagulation being involvedin both primary and secondary haemostasis. It is the site of synthesisof all coagulation factors. Liver damage is commonly associated withimpairment of coagulation. The study involved 60 adult patients ofeither sexes fit for anaesthesia (ASA I-II) prepared for various typesof lower abdominal operations. Two patient categories were assignedinto one of two groups. General Anaesthesia Group (I) including 30patients who received general anaesthesia with isoflurane; 15 of themhad normal liver (Group IA) and the other 15 patients were sufferingfrom CLD (Group IB). Epidural Anaesthesia Group (II): including 30patients who received epidural anaesthesia with ropivacaine; 15 ofthem had normal liver; control group (Group IIA) and the other 15patients were suffering from CLD (Group IIB). Results show thatIsoflurane has a major effect on platelet activation, whether the liveris normal or compromised, while epidural anaesthesia withropivacaine provided better stability in the level of P-selectin.Significant change of PT, PTT, TT, and D-dimer was higher aftergeneral anaesthesia compared to epidural anaesthesia. Generalanaesthesia caused more pronounced changes of vWF activitycompared to epidural anaesthesia. The effect of general anaesthesiaon the fibrinolytic system was significantly higher than that ofepidural anaesthesia, the higher levels in liver disease may be due todecreased clearance. Epidural anaesthesia with ropivacaine ishaemostatically safer than general anaesthesia with isoflurane inpatients with chronic liver disease.