Recent studies have shown that bacterial intestinal dysbiosis, frequently seen in patients with advanced liver cirrhosis may play an important role in the development of serious complications of this condition. The use of probiotics in this context is an attractive idea because of their ability to modulate intestinal flora, improve gut barrier, and their immunomodulatory and anti-inflammatory properties. Both animal and preliminary human studies have demonstrated efficacy of probiotics in reducing infection, hemodynamic disturbance, improving hepatic encephalopathy, parameters of liver function and histology in patients with liver disease. Probiotics are thought to be safe in this group of patients, nonetheless in view of a few studies reporting serious adverse effects in critically ill or immunosupressed patients, caution must be exercised once they are used.