Abstract： Objective To compare the model for end-stage liver disease (MELD) and PT in survival prediction of hepatitis B patients with acute-on-chronic liver failure. Methods One hundred and thirty-nine hepatitis B patients with acute-on-chronic liver failure were divided into survival and death group, and evaluated by MELD and FT. The area under ROC curve was used to compare the MELD and PT. The mortality was observed within 3 months. Results The MELD score and PT of survival group was 25.09 ± 3.92 and (26.46 ± 6.46) seconds respectively, and those for the death group were 36.25 ± 6.42 and (40.78 ± 10.80) seconds. The differences were of statistical significance ( P < 0.01 ). MELD score showed significant correlations with PT(r =0.824, P <0.01). The area under ROC curve was 0.936 (95% CI 0.895 ± 0.977 ) on MELD score and 0. 890 (95 % CI 0.839 ± 0.941 ) on PT, and there was no significant difference between them. Conclusions Both MELD score and PT can accurately predict the short-term prognosis of hepatitis B patients with acute-on-chronic liver failure. The validity of prognosis by MELD is similar to PT. The mortality increases with the MELD score and PT increasing.