Abstract: Objective To conduct a comparative study on the therapeutic effect and safety of autologous bone marrow stem cell transplantation through the portal vein or hepatic artery in the treatment of decompensated liver cirrhosis. Methods A retrospective analysis was performed on the clinical data of 50 patients with decompensated liver cirrhosis who were hospitalized from December 2006 to May 2012. In addition to basic treatment, 25 of these patients underwent ultrasound- guided percutaneous liver puncture and autologous bone marrow stem cell transplantation through the portal vein ( portal vein group) , and the rest underwent radiology- guided femoral artery catheterization and autologous bone marrow stem cell transplantation through the proper hepatic artery ( hepatic artery group) . There were no significant differences in baseline conditions between the two groups. At 2, 4, and 8 weeks after operation, alanine aminotransferase ( ALT) , aspartate aminotransferase ( AST) , total bilirubin ( TBil) , and albumin ( Alb) levels and prothrombin time activity ( PTA) were measured, and improvements in symptoms and adverse events were evaluated.Comparisons between the two groups were made by independent- samples t test; comparisons between values before and after treatment were made by paired t test; categorical data were analyzed by chi- square test. Results Twenty- two cases ( 88. 0%) of the portal vein group showed significant improvements in fatigue and poor appetite, versus 21 cases ( 84. 0%) of the hepatic artery group ( P > 0. 05) . At 8 weeks after operation, the portal vein group and hepatic artery group had serum Alb levels of 34. 4 ± 7. 8 g / L and 33. 8 ± 8. 0 g / L, significantly higher than the values before operation ( 27. 1 ± 8. 9 g / L and 26. 8 ± 9. 6 g / L) ( P < 0. 05 for both) , but there was no significant difference between the two groups ( P > 0. 05) ;the two groups had PTAs of 58. 0% ± 13. 1% and 56. 9% ± 12. 8%, significantly higher than the values before operation ( 45. 5% ± 12. 3%and 47. 0% ± 11. 6%) ( P < 0. 05 for both) , but there was no significant difference between the two groups ( P > 0. 05) . The treatment led to no significant changes in ALT, AST, and TBil levels in either group ( P > 0. 05 for all) . The portal vein group and hepatic artery group had alpha- fetoprotein levels of 10. 3 ± 5. 9 ng / ml and 8. 9 ± 4. 3 ng / ml at 8 weeks after operation, without significant difference between the two groups ( P >0.05) . No severe adverse reactions or complications occurred in either group. Conclusion Autologous bone marrow stem cell transplantation through the portal vein or hepatic artery is safe and effective in the treatment of decompensated liver cirrhosis, and there is no significant difference in therapeutic effect between the two procedures.