Background: Cerebral hemodynamic derangement is well known in patients with liver cirrhosis. Transcranial color coded duplex enables a non-invasive observation of cerebral hemodynamics. To evaluate the clinical usefulness we examined cross-sectionally and longitudinally cerebral hemodynamic parameters in patients with cirrhosis. Objectives: To evaluate the clinical usefulness of the transcranial color coded duplex in hepatic encephalopathy and to evaluate the cerebral hemodynamic parameters in liver cirrhosis.Methods: We are conducting a cross sectional study on 50 subjects divided into 20 Liver cirrhosis patients with encephalopathy within 2 weeks, 20 Liver cirrhosis patients without history of encephalopathy and 10 healthy controls. All patients and control group will be subjected to the following: clinical assessment, laboratory workup in the form of (CBC, PT, PC, INR, Serum albumin, Serum bilirubin (total & direct), ALT, AST, ALP, urea and creatinine), abdominal ultrasonography, transcranial color coded duplex (TCCD) for middle cerebral artery (MCA). The pulsatility and resistive indices of MCA were used as parameters of cerebral hemodynamics. Results: Pulsatility and resistive indices of the middle cerebral artery were markedly higher in cirrhotic patients than in healthy controls. The mean of right MCA resistive index (RI) of control group is 0.568 increased in group ( II ) liver cirrhosis patients without history of encephalopathy to 0.591 , then further increasing in group ( I ) in liver cirrhosis patients with encephalopathy within 2 weeks to 0.62 . The Mean of right MCA pulsatility index (PI) in control group is 0.884 increased in group (II) liver cirrhosis patients without history of encephalopathy to 0. 956, then further increasing in group (I) in liver cirrhosis patients with encephalopathy within 2 weeks to1.031. The mean of left MCA resistive index (RI) of control group is 0.549 increased in group (II) liver cirrhosis patients without history of encephalopathy to 0.591, then further increasing in group (I) in liver cirrhosis patients with encephalopathy within 2 weeks to 0.615. The mean of left MCA pulsatility index (PI) in control group is 0.817, increased in group (II) liver cirrhosis patients without history of encephalopathy to 0. 956, then further increasing in group (I) in liver cirrhosis patients with encephalopathy within 2 weeks to 1.032. Conclusion: Pulsatility and resistive indices of the middle cerebral artery were markedly higher in cirrhotic patients than in healthy controls. The cerebral vascular resistance increased with the severity of liver cirrhosis.