Objectives: The aim of this study is to evaluate the risk factors which lead to post-trans arterial chemoembolization (TACE) hepatic decompensation. Methods: This was a prospective study took place between December 2021 and August 2022 at PEMH, Rawalpindi. After informed consent, 122 patients suffering from hepatocellular carcinoma secondary to chronic hepatitis C were in- cluded who were eligible for TACE as per Barcelona Liver Cancer Algorithm. The baseline variables and post-treatment 30-day variables were noted. Decompensation was assessed using the Child Pugh Score and the ECOG performance score. Baseline variables and demographic variables were compared in patients who developed and did not develop hepatic decompensation. Results: Among the total 122 patients in the study, 95 were males and 64 were older than the age of 50 years. Hepatic decompensation was reported in 54.1% of the total participants. Analysis showed significant association of hepatic decompensation with pre-TACE bilirubin levels, age >50, and pre-TACE alpha-fetoprotein levels. A patient with alpha- fetoprotein (AFP) levels >3200 ng/mL is 2.043 times likely and a patient with age >50 is 4.173 times more likely to have hepatic decompensation after TACE. After TACE, there is increased incidence of ascites and encephalopathy. Conclusion: Hepatic decompensation is commonly encountered in patient’s post-TACE. The predictive factors are age >50, raised bilirubin levels and AFP. >3200 ng/dL.