There is a correlation between esophageal hiatal hernia and cirrhosis, and the complication of ascites during the decompensated phase of cirrhosis can lead to increased intra-abdominal pressure, which may cause esophageal hiatal hernia. The diaphragm separates the thoracic and abdominal cavities, and the esophagus travels down through the esophageal hiatus in the diaphragm. Esophageal hiatal hernia is the entry of tissue outside the esophagus or abdominal organs into the thoracic cavity through the esophageal hiatus. The pathogenesis of the disease includes both congenital and acquired factors, with congenital factors such as being born with a large esophageal hiatus. Most of them are due to acquired factors, such as obesity, pregnancy, ascites, vomiting, etc., which lead to increased intra-abdominal pressure, forcing abdominal organs or tissues into the thoracic cavity. Ascites may form during the decompensated phase of cirrhosis, leading to increased intra-abdominal pressure, so cirrhosis may trigger esophageal hiatal hernia. In addition, the esophagus may shorten as a result of surgical scarring or fibrosis caused by esophagitis, which may pull abdominal organs or tissues into the chest cavity, and may lead to esophageal hiatal hernia. It is recommended to consult a doctor for diagnosis of the specific cause of hiatal hernia.