Background: Lipid changes are common in cirrhotic patients due to the important role of liver in their synthesis and transport. Objective: To test lipid profile changes in Egyptian cirrhotic patients and to examine the effect of liver disease severity on these changes. Methods: Hundred twenty two cirrhotic patients (>18 years) recruited from liver cirrhosis clinic at the National Liver Institute, University of Menoufyia from 2015 to 2017 were reviewed to identify their lipid profile changes. Results: Median age was 56 years (40 – 75 years) and 63% were men. The primary cause of liver disease was hepatitis C (HCV) 86.1%. All tested lipid profile variables, except triglycerides, showed a highly significant negative correlation with the liver dysfunction tested by MELD and MELD-Na scores (All values were p < 0.0001). After grouping patients in four groups according to their MELD score, we founded that the more hepatic dysfunction was associated with more declines in total cholesterol (the four groups means were 161, 139.7, 130.5 and 103.4; p < 0.0001), in HDL (52.5, 51, 44.9 and 29.3; p < 0.0001) and in LDL (100.5, 81.2, 76.5 and 66.9; p = 0.004). Conclusion: Serum total cholesterol, HDL and LDL decrease with liver cirrhosis and their degree of decrease increases with the advancement of liver disease.