Background and aim or the work Gastric varices (GV) are an ominous complication of portal hypertension (PH). The prediction of GV is a mandatory request to avoid their risky bleeding. This work aimed at evaluating the value of Serum- Ascitic Albumin Gradient (SAAG) in prediction of the presence and severity of GV in cirrhotic ascitic patients. Subjects and methods A descriptive cross-sectional study was conducted on 75 cirrhotic ascitic patients. All participants were subjected to full history taking, thorough clinical examination and laboratory investigations including liver function tests, complete blood count, kidney function tests and hepatitis markers including anti hepatitis C virus antibody (HCV-Abs) and hepatitis B surface antigen (HBs-Ag). Abdominal ultrasonography and abdominal diagnostic paracentesis with calculation of SAAG were also done. Patients were also subjected to upper gastrointestinal (GI) endoscopy and they were divided into two main groups according to the presence or absence of GV. Patients with GV were further classified into three groups depending on the form and size of GV. Results SAAG - at a cut off value ≥ 2.4 gm/dl - predicted the presence of gastric varices with 93.28 % specificity, 59.92 %positive predicting value, 66.67% sensitivity and 96.5% negative predicting value. SAAG value also showed a highly significant increase with the progression of grades of GV. Conclusions SAAG - at a cut off value ≥ 2.4 gm/dl - predicted the presence of gastric varices with 93.28 % specificity, 59.92 % positive predicting value, 66.67% sensitivity and 96.5% negative predicting value. SAAG value also showed a highly significant increase with the progression of grades of GV.