Background: The Model for End Stage Liver Disease (MELD) score has been used to predict operative morbidity and mortality of the cirrhotic patient. We sought to determine if the MELD score could be used in risk stratification of Child’s A patients having liver surgery. Further, we looked at the association of the MELD score with lesion histology. Methods: A retrospective chart review was conducted of 136 consecutive patients having hepatic surgery for primary, metastatic, or benign liver disease from 1998-2005. Surgery consisted of ablation and/or resection of liver lesions. Outcomes measured were length of stay, perioperative mortality, and complications. Results: Of the 136 Child’s A patients, there were 98, 28 and 10 patients operated on with metastatic cancer, hepatocellular cancer (HCC), or benign liver lesions, respectively. The mean age was 58.6 years old, range 19-90. For the entire cohort, the mean and median MELD scores were 3.9 and 4.0, respectively, and ranged from -4 to 12. The median length of hospital stay was 7.0 days, ranging from 2-68 days. The average MELD score for patients with a complication was 3.6 versus 4.7 for patients without a complication (p=0.07. Length of stay and perioperative mortality was not associated with MELD scores. The mean MELD scores for patients with metastatic cancer, HCC, and benign liver disease were 3.7, 5.0, and 2.7, respectively (p=0.07). Patients with HCC had a higher rate of 30-day complications (42.9% vs. 23.7%, p=0.05) and a higher 30-day mortality rate (14.3% vs. 1.0%, p=0.0005) than those patients with metastatic disease. Patients with HCC who had a complication had an average MELD score of 6.5 versus 3.9 for those without a complication (p=0.03). Conclusion: MELD score can be used to predict perioperative complications in Child’s A patients with HCC. The MELD score is not helpful in predicting length of stay or perioperative mortality in Child’s A patients having liver surgery.