The current policy for selecting the patients for liver transplantation is “The sickest is the first”. Model for End-Stage Liver Disease (MELD) score is one of the best formula have ever been developed for this purpose. However other factors as serum sodium may be of value in predicting early mortality of such patients, beside it. From September 1998-June 2007 all cirrhotic patients over 14-year-old listed to receive liver transplantation in the Organ Transplantation Center of Shiraz University of Medical Sciences, who had sufficient data entered the study and were fallowed for at least 6 months. Of 612 listed patients, 51 were transplanted and 55 died within the first 3 months and also 29 transplantations and 25 deaths occurred in the next 3 months. Both MELD score and serum sodium were independent predictors of early mortality. In bivariate analysis using these two variables serum sodium remained as a significant predictor of mortality within 90 and 180 days. Again in bivariate analysis serum sodium <130mEq/L had significant strength to predict patients mortality in these period of time beside MELD score. In conclusion, Serum sodium level in addition to MELD score is a significant predictor of early mortality in patients listed for liver transplantation.