Background and aim of the work: Acute upper gastro-intestinal bleeding (UGIB) in cirrhotic patients is a serious event with significant morbidity and mortality. Risk stratification of these patients is warranted to prioritize their admission to the Intensive Care Unit (ICU) and subsequently saving the resources for high risk patients. This study was conducted to triage cirrhotic patients presenting with acute UGIB for ICU admission based on risk factors for poor outcome. Design: The study was conducted on 101 cirrhotic patients presenting to Cairo University Hospitals with acute UGIB. Every patient underwent complete assessment (history, examination, laboratory investigations, abdominal sonography and esophago-gastro-duodenoscopy [OGD]) with special stress on the data that may have impact on the outcome. These data were obtained within 24 hours of admission. Patients with shock and profound encephalopathy were excluded. Poor outcome in terms of death, rebleeding or profound encephalopathy is determined at day five. Patients who develop any of these complications are considered legitimate ICU candidates. Uni-variate analysis revealed that low systolic pressure on admission, increased number of transfused blood units, fresh blood in naso-gastric tube (NGT), decreased hemoglobin, increased bilirubin, decreased albumin, increased INR, increased creatinine, portal vein thrombosis, hepato-cellular carcinoma (HCC), active bleeding during endoscopy, advanced CTP and MELD scores were significantly associated with poor outcome. Multivariate analysis revealed that advanced MELD score, fresh blood in NGT, active bleeding during endoscopy, HCC and portal vein thrombosis are independent prognostic factors for poor outcome in cirrhotic patients presenting with acute UGIB (current model). Conclusion: advanced MELD score, fresh blood in NGT, active bleeding during endoscopy, the presence of HCC and portal vein thrombosis (current model) are considered independent prognostic factors for poor outcome in the setting of acute UGIB in cirrhotic patients and these patients should be admitted to the ICU to improve their outcome.