Malnutrition is common in patients with cirrhosis and is associated with decreased quality of life, increased complications, and increased morbidity post liver transplant. Advancements in the understanding of malnutrition and the limitations of traditional nutrition assessment have spurred the development of new methods of evaluating nutrition status that are particularly applicable to patients with cirrhosis. Nutrition therapy for patients with cirrhosis is also undergoing an evolution. A nutritional screening should be incorporated into the routine clinical care of patients with cirrhosis, with a more extensive nutritional assessment that includes a detailed history, dietary recall, baseline nutrition laboratory tests, and evaluation of sarcopenia using imaging modalities or strength testing to determine the degree of frailty. A thorough assessment will allow for a personalized treatment plan that provides the patient with total daily caloric intake goals with an emphasis on quality protein, education on timing of oral intake with a reduction in periods of fasting, identification and treatment of micronutrient deficiencies, and recommendation of safe and realistic exercise programs to help prevent and/or reduce sarcopenia and improve frailty.