Introduction: The most common thyroid hormone profile in patients with cirrhosis is a low total and free T3 and an elevated rT3, similar to NTIS (nonthyroidal illness syndrome) pattern. Also, the association between thyroid diseases and hepatocellular carcinoma (HCC) has not been well established.Aim: The aim of this work was to study the thyroid hormone status in patients with liver cirrhosis. Also, to correlate thyroid functions with hepatic status in compensated and decompensated cirrhosis, and to study the effect of thyroid dysfunction in development and prognosis of HCC.Methods: The study included 58 patients. Clinical assessment, liver function tests and abdominal ultrasound ± CT abdomen were done. 39 patients had decompensated liver cirrhosis, 11 patients had compensated liver cirrhosis and 8 patients had HCC. The study included 12 healthy controls. TSH, FT4 and FT3 were done to all subjects.Results: The frequency of patients with low FT3 was significantly higher in patients with liver cirrhosis (48%), and HCC (50%) than control subjects (12%) (p-value <0.001). Mean serum FT3 was lowest among decompensated patients (2 pg/ml ± 0.7), followed by patients with HCC (2.5 pg/ml ±0.7) and highest among compensated patients (3.7 pg/ml ± 0.4), p-value <0.001. FT3 showed a significant direct correlation with albumin and PC, an inverse correlation with INR. Logistic regression analysis showed that low FT3, male gender, ulcer bleeding and encephalopathy were independently associated with the development of HCC (OR, 95% CI: 1.1, 0.3-8).Conclusions:Low FT3 is common among patients with decompensated liver cirrhosis and HCC. FT3 shows a significant negative correlation with severity of liver disease and deterioration of liver function. Low FT3 shows a significant independent association with HCC.