PURPOSE: To evaluate the usefulness of renal resistive index(RI) in patients with liver cirrhosis as an indicator for predicting hepatorenal syndrome. MATERIALS AND METHODS: Renal RIs of thirty cirrhotic patients were analyzed using the gray-scale and Doppler ultrasonograms. As a control group, eight normal subjects were alsoincluded. Renal RIs were measured at three sites of interlobar or arcuate arteries of both kidneys. The patients were divided into three groups (A, B, or C) according to the Child-Turcotte-Pugh classification and their serum BUN and creatinine levels were compared. We determined whether RIs of normal controls differed from those of cirrhotic patients or whether RIs of cirrhotic patients correlated with the Child-Turcotte-Pugh classification or BUN and creatinine levels. RESULTS: Mean RIs(0.63 ±0.03) of normal subjects were statistically different from those(0.67 ±0.05) of cirrhotic patients(P=0.009). RIs of group A(n=6), B(n=9) and C(n=15) were 0.65 ±0.03,0.65 ±0.04 and 0.70 ±0.04, respectively. The ANOVA test revealed statistically significant differences between the three groups(F ratio=4.472, P=0.021). RIs did not correlate with BUN or creatinine levels. CONCLUSION: RI could be used as an index for predicting hepatorenal syndrome before the renal function becomes impaired.