Abstract Background Diabetes developed as a complication of cirrhosis is known as hepatogenous diabetes (HD). Around 30% to 60% of cirrhotic patients suffer from this metabolic disorder. Insulin resistance in muscular, hepatic and adipose tissues as well as hyperinsulinemia, seem to be pathophysiologic bases for HD. Objectives to determine the frequency of diabetes mellitus and impaired glucose tolerance in cirrhotic patients in Ain Shams university hospital of pediatrics and identify risk factors. Patients and methods The study included 50 patients, their age is ranging from 6 months to 17 years with chronic liver disease following in the hepatology outpatient clinic (Ain Shams University). These patients were compared according to their fasting plasma glucose, fasting C-peptide, fasting plasma insulin and glycosylated hemoglobin. Results 28% of the patients included in the study were diagnosed as Wilson’s Disease and 24% were diagnosed as extrahepatic biliary system atresia. Thirty patients (60%) showed impaired glucose tolerance, these patients showed hepatomegaly clinically and by ultrasound, also their liver biopsy showed periportal fibrosis and mild to moderate degree of chronic hepatic fibrosis, decreased level of Hemogolbin, high level of liver enzymes especially alanine aminotranferase, and finally high level of Hemoglobin A1C (glycosylated hemoglobin), fasting plasma insulin and fasting C-peptide. Conclusion Most patients with chronic liver disease complicated with liver cirrhosis are liable to develop impaired glucose tolerance and on the long run, they may develop hepatogenous diabetes.