In patients who have been clinically diagnosed with decompensated cirrhosis (DC), progression to more advanced decompensation is associated with high mortality. Therefore, the early detection of the risk of further decompensation is helpful to formulate individual treatment and follow-up schedules for patients with DC. Liver stiffness is a potential prognosis biomarker for patients with cirrhosis. This study evaluated MR elastography (MRE) as a tool to predict the risk of further decompensation. By integrating MRE-assessed liver stiffness with clinical information, we developed a risk score that is valuable for predicting further decompensation in patients with DC.