Abstract Background: The prevalence of Hepatopulmonary Syndrome (HPS) ranges from 5 to 32% from liver-transplantation centers. Egypt is considered as one of the highest countries in prevalence and incidence of bilharizial peri-portal fibrosis and Hepatitis C Virus (HCV) induced liver cirrhosis. Clinical, radiological and laboratory features of HPS were not widely assessed. Objectives: To determine the prevalence, clinical features and laboratory features of HPS among Egyptian cirrhotic patients. Patients and Methods: Our study included 570 cirrhotic patients. Arterial blood gases analysis, chest X-ray, pulmonary function tests and transthoracic contrast echocardiography for detection of pulmonary vasodilatation were done for patients with partial pressure of arterial O 2 80 mmHg. Also, clinical and laboratory features were assessed. Diagnostic criteria of HPS in cirrhotic patients include arterial hypoxemia and pulmonary vascular dilatation on contrast enhanced echocardiography. Results: The prevalence of HPS among patients with liver cirrhosis was 4.2%. Patients with HPS had more severe cirrhosis, as determined by advanced Child-Pugh Grade. The presence of dyspnea, platypnea, clubbing, and orthodoxia was significantly higher in patients with HPS when compared to cirrhotic patients (P value0 .001). In HPS, right pleural effusion and bilateral basal shadows were the commonest radiological findings (20.8% while chest X- ray of most patients with liver cirrhosis was normal (85%) (P value0.05). There was a significant decrease in PaO 2and O 2saturation (P0.001 for each) but a significant increase in P (A-a) O 2 in patients with HPS versus cirrhotic patients (P0.001). Patients with HPS showed a restrictive dysfunction in 59.3%. Conclusion: The prevalence of HPS among cirrhotic patients was 4.2%. The presence of dyspnea, platypnea, clubbing, orthodoxia and arterial hypoxemia were the commonest feature. Right pleural effusion and bilateral basal shadows were the commonest radiological findings.