Background: The current guidelines recommend the screening of all cirrhotic patients by endoscopy, but repeated endoscopic examinations are unpleasant for patients and have a high cost impact and burden on endoscopic units. The aim of this study is to evaluate the accuracy of using right liver lobe size/albumin ratio and platelet count/spleen diameter ratio as potential noninvasive predictors of esophageal varices in cirrhotic patients.Methods: This prospective study included one hundred fifty patients with liver cirrhosis. All studied subjects underwent a detailed clinical examination, biochemical workup, upper gastrointestinal endoscopy and abdominal ultrasound. The platelet count/spleen diameter ratio and the right liver lobe/albumin ratio for all patients were calculated.Results: plt count/spleen diameter ratio, plt count and spleen diameter demonstrated a high statistically significant correlation with the presence and grade of esophageal varices. The plt count/spleen diameter ratio had the highest accuracy, followed by plt count and then the spleen diameter, while the right liver lobe/albumin ratio is the least test in accuracy as we cannot depend on it in diagnosis of esophageal varices.Conclusion: The use of plt count/spleen diameter ratio, plt count and spleen diameter, especially the platelet count/spleen diameter ratio, can help physicians by restricting the use of endoscopic screening only to patients presenting a high probability of esophageal varices. This is especially useful in clinical settings where resources are limited and endoscopic facilities are not present in all areas. While rt liver lobe/albumin ratio can not be used as a non invasive predictor of esophageal varices.