Abstract: Objective To analyze the retinal vascular features of patients with liver cirrhosis, investigate the diagnostic value of retinal vascular parameters for liver cirrhosis, and to evaluate the possibility of utilizing fundus examination as a screening method for liver cirrhosis. Methods Ninety liver cirrhosis patients (liver cirrhosis group) and 93 healthy subjects (control group) were enrolled. The funsus images and retinal vascular parameters including retinal vascular caliber, retinal vascular tortuosity, retinal vascular branching angle and retinal vascular fractal dimension were measured by fundus examination and automated image analysis system. The retinal vascular parameters were statistically compared between two groups. The diagnostic efficiency of single and combined retinal vascular parameters for liver cirrhosis was evaluated by the ROC curve. Results Compared with the control group, the retinal vascular caliber and the retinal vascular branching angle were significantly higher in the cirrhosis group (both P < 0.05). The area under ROC curve for retinal vascular caliber, retinal vascular fractal dimension and the two combined in the diagnosis of liver cirrhosis was 0.869 (95%CI 0.820-0.919), 0.780 (95%CI 0.713-0.847) and 0.901 (95%CI 0.860-0.942), respectively. Conclusions Significant changes in retinal vasculature were found in patients with liver cirrhosis. The retinal vascular caliber and the retinal vascular fractal dimension are of certain value in the diagnosis of liver cirrhosis with relatively high diagnostic efficiency, and the combination of these two retinal vascular parameters yields better diagnostic value. The fundus examination is considered as a potential convenient and non-invasive screening tool for liver cirrhosis.