The liver plays a central role in the metabolism of essential fatty acids; (EFAs; linoleic, linolenic and arachidonic acids). In this work the relationship between EFAs status and the degree of hyperbilirubinemia as well as oxidant stress in infants and children with chronic liver diseases were evaluated. The study was conducted in 30 subjects with chronic cholestasis, 30 subjects with liver cirrhosis and 30 healthy subjects used as control group. Compared with control subjects, both patient groups, cholestatic and cirrhotic groups had significant decrease in EFAs levels (p<0.01), significant elevation of total bilirubin (p<0.0001). In cholestatic group, direct bilirubin was>20% of total bilirubin levels. As regards oxidant stress parameters, both patient groups had significant elevation of thiobarbituric acid reactive substances; (TBARs; p<0.0001 in both groups), significant decrease in retinol, α-tocopherol, and α-tocopherol/total lipids ratio (p<0.0001 in both patient groups for the three mentioned parameters). In cholestatic group, there was a significant inverse correlation between the EFAs level and total and direct bilirubin level. In both patients groups, there was a significant positive correlation between the EFAs level and the levels of retinol, α-tocopherol and α-tocopherol/total lipids ratio, whereas there was a significant inverse correlation between the EFAs levels and the TBARs levels. In conclusion, patients with chronic liver diseases are at a high risk of EFAs deficiency which is correlated with progressive elevation of serum bilirubin and progressive deterioration of oxidant status.