Summary, Conclusion and Recommendation The aim of this work was  To determine whether the cardiac functional and structural disorders are involved directly in the pathogenesis of HRS or merely serves as a marker of an alternative factor that is involved in HRS development.  Relationship between model for end stage liver disease score (MELD score) and cardiac functional and structural disorders in type 1 and type 2 hepatorenal syndrome (HRS)  Relationship between Child pugh score and cardiac functional and structural disorders in type 1 and type 2 hepatorenal syndrome (HRS)  Correlations between serum creatinine and cardiac functional and structural disorders in type 1 and type 2 hepatorenal syndrome (HRS). This study was conducted on 100 patients with liver cirrhosis at various stages (25 patients with compensated liver cirrhosis, 25 patients with decompensated liver cirrhosis,25 patients with type 1 HRS& 25 with type 2 HRS). it included 56 male (56%) and 44 female (44%). The difference in age and sex among the study groups was statistically insignificant (p> 0.01). In this study cardiac structural and functional changes in liver cirrhosis at various stages,patients who were not diabetic or hypertensive, with no history of cardiac disease and no valvular heart disease (that could affect cardiac structure and function) were explored using conventional transthoracic echocardiography& tissue Doppler imaging . There was significant difference as regard mean arterial pressure (MAP) between the study groups. there was a progressive decrease in mean arterial pressure from the first group to the third &fourth Summary, Conclusion and Recommendation 111 group reflecting a progressive deterioration in circulatory function from compensated cirrhosis to development of HRS As regarding the liver function tests; S. albumin(P < 0.001) s.bilirubin (P < 0.001), and INR (P < 0.001), there was a statistical significant difference between the study groups .As regard serum creatinine (P < 0.001), there was a statistical significant difference between the study groups. S. albumin , was progressively decreased from group 1 to group 3&4. s.bilirubin and INR were progressively increased from group 1 to group 3&4. S. creatinine was progressively increased from group 1 to group 3&4. There was significant difference as regard MELD score between the study groups (P