Objective To study the clinical significance of serum prealbumin(PA), serum cholinesterase(CHE) and total bile acid(TBA) levels in patients with liver cirrhosis. Methods Totally 205 patients with liver cirrhosis and 185 healthy people(control group) were enrolled in this study between February 2018 and November 2019. Serum PA, CHE and TBA levels were detected. According to Child-Pugh score, the patients' liver function was classified into A, B and C grades. Serum PA, CHE and TBA levels in patients with different grades of liver function were compared, and the correlation between the above indicators and the patient's condition was analyzed. According to the prognosis in 1-year follow-up, patients with liver cirrhosis were divided into survival group and death group. The prognostic value of serum PA, CHE and TBA levels was analyzed. Results Serum PA and CHE levels in patients with grade C, grade B, grade A liver function, and the control group increased in order, while TBA levels in patients with grade C, grade B, grade A liver function, and the control group decreased in order(P＜0.05). Serum PA and CHE levels were negatively correlated with the grade of liver function, while serum TBA level was positively correlated with the grade of liver function(P＜0.05). Serum PA and CHE levels in the death group were significant lower than those in the survival group, and serum TBA level was significantly higher than that in the survival group(P＜0.05). ROC curve analysis showed that the AUC value and specificity of combined detection were significantly higher than that of single detection(P＜0.05). Conclusion Serum PA, CHE and TBA levels can more sensitively reflect the degree of liver damage in patients with liver cirrhosis, and they are closely related to liver function classification and prognosis. The combination of the three can better predict the prognosis of patients with liver cirrhosis. Therefore, they are expected to be effective indicators for monitoring liver function and prognosis of patients with liver cirrhosis.