Eng stage liver disease is associated with several cardiopulmonary complications, which may adversely affect outcome. There are few, if any, published data in Iranian patients suffering from cirrhosis. The aim is to study the frequency of cardiopulmonary complications in Iranian patients with cirrhosis. In a cross-sectional study ninety-nine (61 men and 38 women, age 15-66, mean age 39.65) of two hundred and eighty-five patients who were registered in Shiraz liver transplantation waiting list from Jan. 2002 till Jul. 2004 were evaluated. Complete cardiopulmonary pre-operation work up was performed for them. Widened alveolar-arterial oxygen gradient [P9A-a)O2], hypoxemia, portopulmonary hypertension, tricuspid regurgitation, hepatic hydrothorax and restrictive lung disease were seen in 61.1%, 14.1%, 6.1%, 12.1%, 4% and 50% of these patients respectively. Widened alveolar-arterial oxygen gradient had negative correlation with presence of pulmonary hypertension (P=0.03) and tricuspid regurgitation (P=0.009). There was a positive relationship between severity of cirrhosis with hypoxemia (P=0.019), but not with portopulmonary hypertension and ventilatory restriction. Portopulmonary hypertension was more common in patient with cryptogenic cirrhosis (P=0.040). Interestingly two patients with portopulmonary hypertension did not have tricuspid regurgitation. Ventilatory restriction had significant correlation with presence of tense ascites (P=0.040) and hepatic hydrothorax (P=0.022). In conclusion, cardiopulmonary complications are common in Iranian patients with cirrhosis, widened alveolar arterial oxygen gradient and portopulmonary hypertension seems to have different pathogenesis in this study.