Hepatopulmonary syndrome (HPS) is one of the pulmonary complications ofliver cirrhosis which affect the disease treatment and prognosis and is a factor for arterial blood oxygen reduction. This syndrome is characterized by a triad of presence of liver cirrhosis andarterial blood oxygen reduction found in arterial blood gases test and intrapulmonary vascular dilatation confirmed by contrast enhanced echocardiography.Objectives of study were to illustrate the manifestations and how to diagnose the hepatopulmonarysyndrome in cirrhotic patient according to Child-Pugh classification.Methods: -Suitable numbers of cirrhotic patients undergo the followings:-1- History and full physical examination as well as clinical features related tohepatopulmonary syndrome including dyspnea, clubbing, cyanosis, spider andcollateral veins. 2- Liver function tests (alanine aminotransferase (ALT), aspartateaminotransferase (AST), alkaline phosphatase, albumin, total bilirubin, direct bilirubin andprothrombin concentration).3- Hepatitis markers :-HBsAg, HBsAb, HBcore Ab, HCV Ab. 4- Arterial blood gases in recumbent position and after standing for 20 min to detectorthodeoxia.5- Contrast enhanced echocardiography.Results:- Positive cases for HPS were detected in 6/60 (10%) all of them are child C. Dyspneahas the maximum sensitivity (100%) in HPS cases, followed by cyanosis (83.33 %), spider (83.33 %) and p. erythem (83.33 %). Platypnea (100 %) and clubbing (94.4 %) were the most specific clinicalfeatures. All patients with HPS are child C with albumin level below 3 and PC less than 50%suggesting that HPS development is related to liver synsthetic dysfunction. PO2 was less than 70mmHg in (100%) of cases andwas less than 60 mmHg in (50%). Orthodeoxia was present in (66.66 % of HPS and 0 % of nonHPS patients) with 66.66 % sensitivity and 100% specificity.Conclusion:- Hepatopulmonary syndrome (HPS) is one of the pulmonary complications ofliver cirrhosis. The severity of HPS is clearly correlated with the degree of liver disease. Dyspneahas the maximum sensitivity followed by cyanosis, spiders and palmer erythema. Platypnea andclubbing were the most specific clinical features. Orthodeoxia strongly suggest the diagnosis ofHPS with 100% specificity