Background: Surgical treatment of umbilical hernia in patients with chronic liver disease is challenging. The attitude in the repair of these hernias varies from elective treatment in early stages of the disease to the surgical intervention only if it is complicated. Objectives: To evaluate the outcome of emergency surgery for the complicated umbilical hernias in patients with chronic liver disease. Patients and Methods: Emergency surgery was done for 22 consecutive cases whom had complicated umbilical hernia and chronic liver disease. Surgery was done in the surgical departments of "Al-Azhar university hospitals" between January 2012 and February 2013. The stages of liver disease were classified based upon Child-Pugh classification. Complications that required emergency repair were: strangulation, irreducibility (symptomatic) and hernia rupture. Surgery was done under local anesthesia in (18 cases), or spinal anesthesia in other 4 cases. Postoperative complications were ordered in five grades of severity based upon Clavien classification. Results: The severity of the complications was significantly high in advanced stages of liver disease; (Child B and C). There were 5 deaths, representing 22.2 %, four of them were in Child C group. Conclusion: The incidence of morbidity and mortality after emergency repair of umbilical hernia increases in advanced stages of liver disease. To avoid such complications, it is advisable to repair these hernias in elective conditions