Background and aims Liver cirrhosis is a major public health problem in Egypt due to widespread infection of hepatitis C virus. Mean platelet volume (MPV) is a noninvasive, inexpensive parameter of complete blood count. In this study we aimed at evaluating the association between MPV and clinical features, complications, and severity of cirrhosis in Egyptian patients. Patients and methods One hundred and fourteen patients with cirrhosis of various grades of severity and various presentations were enrolled in our study. The patients were evaluated to assess the association between MPV values and cirrhosis parameters, model for end-stage liver disease score, and fibrosis (FIB4) score. Results The study demonstrates the positive correlation between MPV values and international normalized ratio, serum bilirubin, lower serum albumin in cirrhotic patients. Also, the MPV values were significantly higher in patients with more severe liver disease according to the model for end-stage liver disease (r=+0.424, P=0.008) and FIB4 scores (r=+0.353, P=0.03). Conclusion MPV can be used as an important inexpensive biomarker in cirrhotic patients for the degree of severity and prognosis of the disease