Introduction and objective. The deficiency of the Lysosomal acid lipase (LAL) activity has been related to cirrhosis due to non-alcoholic steatohepatitis (NASH). Many of the cirrhosis classified as cryptogenic are the evolution of liver disease due to fatty liver. The objective of the present study was to evaluate the lysosomal acid lipase (LAL) activity in the patients with liver cirrhosis of any etiology and establish whether low levels correlate with cryptogenic cirrhosis of origin cryptogenic or NASH. Methods. Was an analytical cohort study including 96 patients with cirrhosis of any etiology for which LAL activity was measured. Results. Fifty-five patients (58%) with cryptogenic cirrhosis or NASH were included and 41 with other etiologies. The fifty-three percent of the total population were women. The severity scores of liver disease were significantly higher in the patients with the cryptogenic cirrhosis or NASH: MELD (11.72 ± 7.3 vs 4,34 ± 5.7; p = 0.001) and Child-Pugh (7.26 ± 3.8 vs 7.26 ± 3.8; p = 0.004). LAL activity was significant lower (202.40 ± 98.8 vs 242.55 ± 121.9; p = 0.04) in the cirrhosis cryptogenic or NASH group. In the multivariate analysis, low LAL activity (< 150 nmol/spot/hour), was correlated with the presence of cryptogenic cirrhosis or NASH. Conclusions. The patients with cryptogenic cirrhosis or NASH have lower levels of LAL activity than those with cirrhosis of other etiologies. LAL activity below 150 nmol/spot/hour is predictive of the cryptogenic cirrhosis or NASH.