The optimal management of umbilical hernia in patients with decompensated liver cirrhosis with or without ascites who are potentially recipients of liver transplant remains a matter of debate and poses unique and specific management problems due to the pathophysiology of cirrhosis and high post-operative complications. If left untreated, abdominal wall defects in cirrhotic patients may grow to immense sizes and can be associated with life threatening complications that demand urgent surgical intervention. Hereby the authors thought to find out a safe minimal invasive procedure which could be alternative to surgery. Here we present our success to manage such dilemma in 2 decompensated patients awaiting for liver transplantation, presented to our center with incarcerated Para-umbilical hernia, complete aspiration of the fluid inside the sac was done for those patients - guided ultrasonography. In addition, the distended intestine inside the sac was deflated, and then the hernias have been reduced completely. Cirrhotic decompensated patients with incarcerated umbilical hernia would be managed safely with that described procedure as an alternative to surgery or/and at least to be a bridge for later safe elective surgery if indicated after relieve of the intestinal obstruction.