Background: Lipid metabolism is impaired in different directions in liver cirrhosis. Dyslipidaemia seen in cirrhosis of the liver differs from that found in most of the additional reasons of secondary dyslipidaemias because lipoproteins in circulation are not only present in unusual amount but they also often have unusual composition, electrophoretic movement and forms (Nangliya et al., 2015). Materials & Method: This cross-sectional study was carried out in the Department of Biochemistry, Sylhet MAG Osmani Medical College, Sylhet during the period from 1st January 2016 to 31st December 2016.Fiftypatients with cirrhosis of liver fulfilling the inclusion criteria were enrolled as group-A and 50 age-sex matched healthy adults were selected as the control group (group-B). Result: Fasting serum total cholesterol was estimated. Severity of liver Cirrhosis was categorized according to Child-Pugh scoring system and increasing severity was categorized as Child Pugh class A, B and C.Serum total cholesterol is decreased in patients with liver cirrhosis. The level of severity of liver damage significantly affects the serum total cholesterol level in cirrhosis; and may be considered as markers of severity of liver damage in cirrhosis. Conclusion: It may be concluded that hypocholesterelemia exists in patients with liver cirrhosis and screening for severity of cirrhosis by serum total cholesterol is important for intervention with appropriate therapy to reduce the severity of the disease. Key words: Liver cirrhosis,Serum total cholesterol , Child-Pugh score.