Introduction:Cirrhosis is defined anatomically as a diffuse process with fibrosis and nodule formation. It is the result of fibrogenesis that occurs in chronic liver injury. Diffuse fibrosis causes architecture distortion with regenerative nodule formation resulting in decreased liver cell mass and reduced blood flow to the liver.In India,the most common cause of cirrhosis is alcohol abuse and viral hepatitis. Reversible fibrosis with ongoing injury over timedevelops a decompensated condition (DCLD) that is associated with one or more complications like ascites, jaundice, and hepatic encephalopathy & the major being the development of esophageal varices with the associated risk of variceal bleeding.The Baveno consensus on portal hypertension in its first five editions has recommended surveillance with periodic upper endoscopies in these patients to identify in a timely fashion the development of esophageal varices and initiate a primary prophylaxis strategy in those at a high risk of bleeding. Aim: • To study the clinical factors predicting the presence of esophageal varices in patients with liver cirrhosis. Objectives: 1. To study the various factors such as pallor, pedal oedema, jaundice, Child Pugh’s score, MELD score, and spleen size to predict the presence of esophageal varices in patients with liver cirrhosis.To avoid unnecessary endoscopy for varices screening.To determine the sensitivity and specificity of predictive factor score for the development ofvarices. Methods:It is a descriptive study conducted at Amala Institute of Medical Sciences from January 2022 to June 2023 (18 months), evaluating 165 patients with liver cirrhosis.After obtaining informed consent from patients for inclusion in the study, proper history to identify the initial presentation and find out the cause of cirrhosis was taken. Pallor, icterus, splenomegaly with USG, and pedal edema were looked for in every patient. CHILD score and MELD score were also calculated. Screening endoscopy was performed in all patients.All the above data were analyzed and the parameters that correlated with varices were selected. The predictability of varices from these indices was calculated.From this study, we wanted to eliminate patients who can avoid unnecessary endoscopy.The data was collected and entered in MS Excel and worksheet. The analysis was done using SPSS software (Version 23.0).The difference of incidence and severity of selected factors were analysed using logistic regression and sensitivity and specificity of various factors were obtained.Results:In our study group of 165 patients with cirrhosis, 68.5% were males and the rest were females. 44.2 % of patients presented with pedal edema and it was the most common initial presentation. This was the most common clinical finding 52.7% of the patients had pedal edema on examination.The most common etiology of cirrhosis was alcohol which was 53.3%.It was observed that jaundice, hemoglobin, and albumin levels could predict the chances of developing varices which was statistically significant, and they were independent risk factors for developing varices.The cut off for each variable was obtained above and below which chances of varices was more. The values obtained were bilirubin>0.959, Hb<10.05, MELD>9.50, usg spleen size>9.9cm, and albumin <3.45 had a significant risk of varices.Conclusion:Our study concluded that patients with bilirubin less than 0.959, albumin more than 3.45 and can avoid screening endoscopy after initial detection of cirrhosis.