Liver transplantation is considered to be the only curative treatment in decompensated liver disease. Shortage of liver allografts is a major impediment for widespread application of this procedure. ABO-incompatible grafts have been used successfully thereby increasing the LDLT donor pool. However, ABO-I liver transplantation is associated with complications like acute liver rejection, hepatic artery thrombosis and higher biliary stricture rates leading to transplant failure, re-transplantations or sepsis-related complications. Various desensitization strategies have been adopted which have improved outcomes. Biologically-related donor-recipient pairs have theoretical advantage of favourable HLA match. We have analysed the outcomes of ABO-incompatible LDLT and compared the results of HLA-matched (biologically-related) and HLA-unmatched (biologically-unrelated) donor-recipient pairs. Retrospective data of 90 cases of ABO-I liver transplant recipients: HLA matched (n=35) and HLA un-matched (n=55) for comparison of pre-operative and post-operative data. Peak bilirubin level in HLA-unmatched recipients were higher. Platelets count were lower than HLA-matched recipients (7.3mg/dL vs 8.9mg/dL). No significant difference in days-to-normal bilirubin, peak INR, hospital stay and discharge-day from transplant between both groups. Post-operatively, HLA-unmatched recipient required more pulse-steroids therapy than HLA-matched - 21/55 (38.2%) vs 11/35 (31.4%). Biliary complication and intervention were more in HLA-unmatched group (12/55, 21.8%) than HLA-matched (4/35, 11.4%). Renal complications requiring post-operative haemodialysis was more in HLA-unmatched group than HLA-matched group 9/55 (16.4%) vs 3/35 (8.6%). The incidence of vascular complications was similar. ABO-I LDLT is an effective and safe method for increasing the donor pool in absence of ABO-C liver donor. Long term outcomes of recipients with biologically-related donors are marginally better than biologically-unrelated ABO-I LDLT recipient. However, incidence of antibody-mediated graft rejection and biliary complications are more in biologically-unrelated ABO-I liver recipient.