Plasma amino acid concentrations and urinary excretion of free amino acids were measured in 7 patients with severe hepatic decompensation (precoma) in Laennec's cirrhosis. Upon maximal improvement these patients served as their own controls. Contrary to earlier reports, the changes were found to be unspectacular. Plasma concentrations of amino acids proved to be remarkably stable. Decreased plasma concentrations of valine, leucine, and isoleucine pointed to a component of steatonecrosis, which was found in liver biopsy specimens and laboratory parameters. The urinary excretion of threonine, serine, asparagine/glutamine, alanine, ethanolamine, and histidine was increased significantly during hepatic decompensation when compared to the excretion values of the same patients at maximal compensation; but even here the changes were within the normal range. General aminoaciduria was observed in 3 cirrhotic patients who had undergone surgical portacaval shunts. It is possible that these changes are a sequence of the surgical procedure. © 1969 Hoeber Medical Division • Harper & Row, Publishers, Incorporated.