AIM To compare predictive ability of Budd-Chiari syndrome(BCS) prognostic indices(PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt(TIPS) patency.METHODS This retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the BuddChiari Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs(Clichy, New Clichy andRotterdam) for all patients, and BCS-TIPS PI only for patients who underwent TIPS. The overall one-year survival rate and the one-year shunt patency rate for TIPS were reported.RESULTS The overall one-year survival rate was 69.6%, and the New Clichy PI revealed the best validity for its prediction at a cut-off value of 3.75, with sensitivity and specificity of 78% and 73.3%, respectively [area under receiver operating characteristic curve(AUC) = 0.806]. The one-year survival rate post-TIPS was 89.7%, and the BCS-TIPS score demonstrated validity for its prediction at a cut-off value of 3.92(sensitivity and specificity were 71.4% and 64.5%, respectively)(AUC = 0.715). Logistic regression analysis revealed that the New Clichy PI(P = 0.030), high serum total bilirubin(P = 0.047) and low albumin(P < 0.001) were independent factors for predicting mortality within one year. The one-year shunt patency rate in TIPS was 80.2%, and none of the PIs exhibited significant validity for its prediction. CONCLUSION The New Clichy score could independently predict the one-year survival in Egyptian BCS patients. AIM To compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency. METHODS This retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the Buddhihi Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs (Clichy, New Clichy and Rotterdam) for all patients, and BCS-TIPS PI only for The patients who underwent TIPS. The overall one-year survival rate and the one-year shunt patency rate for TIPS were reported. RESULTS The overall one-year survival rate was 69.6%, and the New Clichy PI revealed the best validity for its prediction at a cut-off value of 3.75 with sensitivity and specificity of 78% and 73.3% respectively [area under receiver operating characteristic curve (AUC) = 0.806]. The one-year survival rate post-TIPS was 89.7%, and the BCS -T Logistic regression analysis revealed that the New Clichy PI (P = 0.030), high (P = 0.030) The one-year shunt patency rate in TIPS was 80.2%, and none of the PIs were statistically significant for its prediction. (P = 0.047) and low albumin CONCLUSION The New Clichy score could independently predict the one-year survival in Egyptian BCS patients.