Background: Cirrhotic patient develops esophageal varix due to portal hypertension also increase the risk of developing 
encephalopathy. Hepatic encephalopathy is a neuropsychiatric syndrome caused by liver disease that occurs in 30-40% of patients with cirrhosis. Minimal hepatic encephalopathy (MHE) is a state in which patients with cirrhosis of liver regardless of its cause show a number of quantifiable abnormal psychometric tests. This study aimed to see the association of severity of esophageal varix with Minimal Hepatic Encephalopathy in patients with Cirrhosis of Liver. Methods: This hospital based observational analytical study included 40 patients with Cirrhosis of liver admitted to the Department of Medicine, Rajshahi Medical College Hospital from JulyDecember 2012. Complete history was taken either from patients or accompanyingattendants. Thorough clinical examination was done. Relevant investigations report was collected. All the information’s were recorded on the fixed protocol. Collected data was classified, edited, coded and entered into the computer for statistical analysis by using SPSS. Results: Severity of liver disease according to Child-Pugh Grading, Grade-A was 02(5%), Grade-B was 30(75%) and Grade-C was 08(20%). Prevalence of number connection tests positive was 15(37.5%), line tracing test positive were 15(37.5%), serial dotting test positive were 16(40.0%) and two test positives were 15(37.5%). Association between line tracing test with ChildPughGrading, out of 15 positive line tracing test, 09 had Grade-B and 06 had Grade-C, p value was (p<0.05) that was statistically significant. Association between serial dotting tests with Child-Pugh Grading, out of 16 positive serial dotting tests, 09 had Grade- B and 07 had Grade- C, p value was (p<0.05) that was statistically significant. Association between psychometric tests with esophageal varix by Paquet’s grading, out of 40 patients 15 patients were grade-III, who were psychometric test positive groups and 16 patients were grade-III and 09 patients were grade-II who were psychometric test negative groups, p value was (p<0.05)statistically significant. In psychometric test positive groups mean duration of disease were 7.25(1.12) monthsandpsychometric test negative groups were 5.09(1.99) months, p value were (<0.001) that was statistically significant.Conclusion:Minimal hepatic encephalopathy (MHE) is common in patients with stable cirrhosis of liver. There is a goodrelationship between MHE with advanced liver disease by Child-Pugh Grading. Esophageal varix with high grade severity iscommon in cirrhotic patients who have MHE and longer duration of disease.