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Background. Acute variceal bleeding (AVB) is a potentially life-threatening condition associated with high mortality among cirrhotic patients. Various risk scores are used in risk stratification for non-variceal bleed, but their utility in AVB remains unclear. OBJECTIVE: The aim of the study is to compare systems in predicting in-hospital mortality in cirrhotic patients with acute variceal bleeding - Model for End-Stage Liver Diseases (MELD), Child-Pugh, Glasgow-Blatchford Bleeding (GBS) and Rockall scores. Methods. We retrospectively included all cirrhotic patients admitted to the emergency room with acute variceal hemorrhage between 2017 to 2021, that underwent upper gastrointestinal endoscopy with endoscopic hemostasis (band ligation) in the emergency department of SCJU Targu-Mures. Results. A total of 210 patients were included (male/female: 165/45; mean age: 59.12±11.76 years; Child-Pugh class A/B/C: 47/91/72). The main endpoint of the study was the in-hospital outcome, 83% of patients (n = 175) survived while 17% (n = 35) died. The mean Glasgow-Blatchford score was 12.68 ± 3.25 vs 15.31 ± 2.91 (p<0.0001), Rockall score 6.98 ± 0.86 vs. 7.68 ±1.02 (p<0.0001) and MELD score 12.78±4.73 vs. 15.31±2.91 (p<0.0001). Areas under receiving-operator characteristics curve (AUROC) for predicting the in-hospital mortality were compared. AUROCs for predicting the in-hospital mortality for Child-Pugh score was 0.714 (95% confidence interval [CI]: 0.648-0.774), GBS 0.731 (95% CI: 0.666-0.790), MELD score 0.767 (95% confidence interval [CI]: 0.704-0.823), respectively for Rockall score was 0.699 (95% confidence interval [CI]: 0.632-0.760). Conclusions. The present study shows that MELD score is an excellent indicator in in-hospital mortality of acute UGIB in cirrhotic patients. [ABSTRACT FROM AUTHOR]