The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial desaturation, and pulmonary vascular dilatation. The reported prevalence of HPS in adult cirrhotic patients varies between 4% and 19%, and various threshold values defining arterial desaturation have been used and recommended previously. We studied 114 pediatrics patients (£ 18y) for the presence of HPS, using contrast enhanced echocardiography for detection of pulmonary vasodilatation and blood gas analysis for hypoxia. Sixty patients (52%) had positive contrast enhanced echocardiography that means 52% of patients had intrapulmonary venous dilatation, of 71 patients with ABG (Arterial blood gas) 25 patient have positive contrast enhanced echocardiography with Pao2 <70 that means 35.5% of our patients fulfilling the criteria of hepatopulmonary syndrome.We concluded that pulmonary venous dilatation and hepatopulmonary syndrome are common finding in children with chronic liver disease. In dependent to causes the prevalence was higher than those reported in adulthood that means more vascular responsiveness or angiogenesis in children. Ejection and shortening fraction were normal or high and no one had indirect sign of pulmonary hypertension.