Background: Liver cirrhosis is associated with high morbidity and mortality. MicroRNAs (miRNAs), a class of endogenous small non-coding RNAs, are becoming increasingly recognized as crucial regulators in gene expression networks. In particular, a low serum miRNA-122 level was associated with hepatic decompensation so it can be used as a prognostic marker for liver decompensation. Aim of work : Circulating miRNAs was examined aiming to clarify its prongnostic value in patients with liver cirrhosis and to discover its relation with patients survival. Methods: RNA was extracted and assessed from sera of 100 patients with liver cirrhosis, using quantitative reverse-transcription PCR (RT-PCR) . MiRNA 122 levels were compared to liver function tests, MELD score, overall survival time and to different manifestation of decompensation. Results: Serum miRNA-122 levels were significantly decreased in patients with hepatic decompensation when compared to patients with compensated liver cirrhosis. Patients with ascites, and hepatorenal syndrome had significantly lower miRNA-122 levels than patients without these complications. A univariate Cox regression analysis revealed a significant association between miRNA-122 levels and overall survival Multivariate Cox regression analysis revealed that only miRNA-122 serum levels and platelet count were associated with survival. MiRNA-122 sensitivity and specificity for the predection of decompensation in cirrhotic patients were 100.0% and 90.1% respectively the best cut off point value of 0.892 (AUC= 0.9429) Conclusions: Serum miR-122 is a new independent prognostic marker of patients with liver cirrhosis..