Background: Liver injury that leads to necro inflammation and fibrogenesis causes cirrhosis. Histologically this disease is characterized by diffuse nodular regeneration surrounded by dense fibrotic septae, so parenchymal extinction and collapse of liver structure occur together causing pronounced distortion of hepatic vascular architecture. Patients with cirrhosis in the ICU benefit from a team approach of clinicians with expertise in both hepatology and critical care. The goals of treatment are to prevent further deterioration in liver function, reverse precipitating factors, and support failing organs. Liver transplantation is required in selected patients to improve survival and quality of life. Several ICU and liver-specific scores have been used to predict outcomes of critically ill patients with cirrhosis. Most of the studies tended to establish predictive models using prognostic scores to explore the 30-day outcomes of patients. The increased effectiveness of supportive treatments and the spread of liver transplantation programs have improved the prognosis of these patients. Child–Turcotte–Pugh (CTP) is widely applied in predicting the 1-year survival rate in patients with cirrhosis. The Mayo End-Stage Liver Disease (MELD) score has been validated in determining the severity of liver dysfunction, 3-month mortality, and the suitability for liver transplantation. The Chronic Liver Failure Consortium—Acute-on-Chronic Liver Failure (CLIF-C ACLF) score has been introduced recently and found to be superior to CTP and MELD scores in predicting short-term (28-day) mortality as well as medium-term (90-day) mortality in both ICU patients and those who were admitted in the ward.