Background: Cirrhotic cardiomiopathy is described as the presence of cardiac dysfunction in cirrhotic patients. BNP is a cardiac neurohormone released in response to increased ventricular wall tension. The level may be elevated in cirrhotic patients. The aim of the study: was to evaluate cardiac dysfunctions in cirrhotic patients and its relationship to BNP plasma level.subjects and method: we conducted a cross sectional study on fifty two cirrhotic patients following up at the hepatology clinic in Cairo University Children Hospital and fifty three healthy controls; where they were assessed by conventional echocardiography , Doppler and Tissue Doppler Imaging (TDI) for systolic and diastolic functions &BNP plasma level was measured for both groups using quantitative ELISA technique for BNP supplied by WKEA MED SUPPLIES CORP.Results:We compared the echocardiographic findings of both cases & controls. The cases had significantly increased diameter of the left atrium, right ventricle, pulmonary artery& posterior wall thickness (P value =0.01, 0.02, 0.04&0.04). Using Doppler echocardiography, the E/A of both mitral & tricuspid valves inflow were significantly lower in cases (p value of 0.005 &0.0008) and also A wave velocity of tricuspid valve was significantly higher in cases (p value of 0.001).By using TDI, cirrhotic patients had significantly higher IVRT& lower IVCT of mitral valve inflow (p value of 0.008, 0.03). Patients also had significantly higher Ś wave velocity, É & Tie index & significantly lower IVCT of tricuspid valve inflow (p value of 0.01, 0.0003, 0.01 and 0.02 respectively). Also lower É & higher Ś wave velocity of the septum which was statistically significant in cases as compared to controls (p value of 0.04 & 0.001 respectively). The BNP levels were significantly higher in cases as compared to controls (p=0.04). But it was of no statistical difference when compared between compensated & decompensated patients. In patients with cirrhosis, the only echocardiographic parameter that was significantly correlated with the BNP level was the E wave velocity on tricuspid valve (p=0.004). Conclusion: Cirrhotic patients have a degree of cardiac dysfunction. BNP is a useful & specific marker of cardiac dysfunction in cirrhotic patients