Background: Liver cirrhosis is major global cause of morbidity and mortality. Serum cholinesterase is synthesized by liver and compared to other enzymes serum cholinesterase is decreased in liver dysfunction. Liver cirrhosis severity is calculated by Child Pugh score in which Class A (5-6) show mild disease Class B (7-9) show moderate disease and Class C (10-15) show severe disease. Material and methods: Present hospital based cross sectional study was single centric, conducted in 80 liver cirrhosis patients. Serum cholinesterase was measured within 72 hours of admission using colorimetric methods. Child Turcotte Pugh scores (CTP) were used to assess the severity of liver disease in patients with cirrhosis. Statistical analysis was done using SPSS, Version 2.0. Results: In the present study majority of participants are between the ages of 40 and 49 years with males outnumber the females (91.3%). Alcohol is the common cause of about 75% of patients. There were two patients in child class A, twenty-six in class B, and fifty-two in class C. Mean serum cholinesterase is 1728 with standard deviation of 979 IU/L. Serum cholinesterase had significant correlation among Child pugh score (p <0.001) and was positively correlated with albumin and negatively correlated with serum plasma prothrombin time. Conclusion: Serum cholinesterase had significant correlation with Child pugh score in liver cirrhosis and can be used in routine clinical practice.