Estimation and modification of operative risk in patients with liver disease is given in detail. Operative risk in patients with liver disease, liver disease risk assessment tools, Child-Turcotte’s classification, Child-Turcotte-Pugh’s score, model for end stage liver disease score, operative risk in liver disease, risk for abdominal surgery, risk modification and anesthetic implications are described in detail. 5 tables are included for better understanding. A flow chart is included to highlight management algorithm for patient with liver disease. 77 references are given at the end of the chapter to facilitate further reading.