Background <p>One of serious side effects of liver cirrhosis is spontaneous bacterial peritonitis (SBP), which is defined by existence of infected ascites without a discernible secondary source of infection. One possible mechanism for development of SBP is microbial translocation.</p> Objective <p>To ascertain prevalence, microbiological profile and outcomes of spontaneous bacterial and fungal peritonitis in Egyptian patients with liver cirrhosis.</p> Methods <p>Three hundred cirrhotic patients with ascites who were hospitalized for spontaneous peritonitis (SP) participated in cross-sectional research. Laboratory investigations using bacterial and fungal cultures were carried out.</p> Results <p>All participants with diagnosis of SP were included. Their mean age was 59.50 years, and 68.7% of them were men. In addition, 13.7% of subjects had spontaneous fungal peritonitis, whereas 47.3% of participants had SBP. Of SBP cases, 50.7% (<i>n</i> = 72) had gram negative (-ve) bacteria isolated from them, whereas 49.3% (<i>n</i> = 70) had gram positive (+ ve) bacteria. Streptococcus 8.5% (<i>n</i> = 12) was the commenest gram-positive isolate, followed by Staphylococcus aureus 33.8%(<i>n</i> = 48). On the other hand, Klebsiella 29.6% (<i>n</i> = 42) was the commenest gram-negative isolate, followed by Escherichia coli 14.4%(<i>n</i> = 19). The outcome of SBP cases with and without multidrug resistance do not differ significantly. On multivariate analysis, femal (<i>p</i> = 0.013), low ascitic protein level and high ascitic lactate dehydrogenase (LDH) (<i>p</i> = 0.018, <i>p</i> = 0.014) were significant independent predictors for SFP.</p> Conclusion <p>SBP and SFP frequently provide serious life-threatening dangers in cirrhotic patients with ascites. Alertness for SFP is increased with low ascitic protein level and high ascitic LDH.</p>