The prospective studywas conducted on 100 consecutive patients of acute on chronic liver failure for a period of 1 year.ACLF has a predominant male preponderance with a male:female ratio of 93:7. The mean age of patients presenting with ACLF was 40.88 ± 1.1 yrs.The study group patients were divided into 3 subgroups on basis of presentation.Out of the 3subgroups, most of the patients belonged to sub group Ai.e undiagnosed cirrhosis was already present in most of the patients with ACLF.All the patients had history of jaundice on presentation (100%) followed by abdominal distension and ascites(89%) and hepatic encephalopathy (45%).Ultrasonography was carried out in 100 patients in which all patients had ultra sonographicevidence of chronic liver disease followed by  ascites (92%) and varices (53%).The hepatitis viruses were also one of the common acute insult in our study.Hospital stay and in hospital mortality of 14 days and 4 patients were found respectively.These findings were essential for the critical management of the disease.