Back ground: Open heart surgery in liver cirrhosis patients with is associated with significant increase in perioperative morbidity and mortality. Methods: Prospective study to evaluate the outcome of elective open heart surgery in patients with liver cirrhosis. Results Total 75 patients, 67 were A Child-Pugh and 8 patients were class B Child-Pugh. No alcoholic or class C patients were included in the study. 59 patients were Hepatitis C positive , 13 Hepatitis B positive and 3 patients were positive for both Hepatitis B and C. 67patients (89%) male, 8 female (11%), 23hypertensives and 18(24%)were diabetics. Mean EF was 48.76±7.19.Mean CPB time was 59.28±20.31min and mean CX time 42.48±15.06min. Mean ventilation time was11.51± 8.62. Mean chest tube drainage 944.80±620.554 ml, minimal 190ml maximum 3500 ml .15 patients re-explored for bleeding, (20%). Mean ICU stay was 67.68± 21.91hours. 16 patients (21.3%) had wound infection, 11 had superficial and 4 had deep wound infection. The mean hospital stay was 9.18±2.291days.Total morbidity was 55.33%, 49%in class A patients and 86.5% in class B patients. Four patients died with total mortality 5.3%, in class B patients was 37.5% mortality and 1.49% in class A patients. Conclusion: Open heart surgery in liver cirrhosis patients carries high perioperative morbidity especially postoperative bleeding and increase in incidence of infection with expected high mortality.