OBJECTIVES::  To evaluate the main factors related to high cost to the patient on the waiting list for liver transplant METHODS:: A microcosting based study in a cohort of 482 cirrhotic patients registered on waiting list for liver transplant followed by 24 months was performed. All the amount of each resource and procedures used were acquired and the unitary cost of each component used was calculated and thus, the individual cost for each patient was obtained. RESULTS:: After 24 months of cohort, 132 patients had MELD<= 17 (27.39%), 122 had MELD 18-24 (25.31%), 113 patients had MELD 25-30 (23.44%) and 115 patients had MELD>30 (23.86%). The total expenditure of the 492 patients followed by 24 months on the waiting list for liver transplant was US$ 6,064,986.51 and of these total, (US$ 1,965,045.52) 32.4% cost in outpatient care and (US$ 4,099,940.99) 67.60% cost in hospitalizations. The total cost of patients on the waiting list for liver transplantation was higher in those with MELD score between 25 and 30 (US$ 16,686.74 ± 16105.02) and lower among those with MELD below 17 (US$ 5703.22 ± 9318.68) CONCLUSIONS::  The cost of the cirrhotic patient on waiting list increase as increase the MELD score. Some high-cost patient has total expenditure more expensive than the cost of liver transplant. The main cost drivers for this treatment were hospitalizations, blood reposition, and hepatocellular carcinoma treatment.