Objective To investigate the predictive value of red cell volume distribution width (RDW) to platelet ratio (RPR), γ-glutamyltransferase to platelet ratio index (GPRI), S-index, fibrosis index based on the 4 factor (FIB-4) and aspartate aminotransferase (AST) to platelet ratio index (APRI) in the non-invasive serum models in assessing esophageal varices in patients with alcoholic liver cirrhosis. Methods Totally 126 patients with alcoholic liver cirrhosis including 20 cases of patients complicated with mild and moderate esophageal varices (mild and moderate group), 67 cases of severe esophageal varices (severe group) and 39 cases of non-esophageal varices (non-varices group) were enrolled. Blood routine (RDW and PLT) and liver function (ALT, AST, GGT and ALB) were tested, and RPR, GPRI, S-index, FIB-4, APRI were calculated. Receiver operating characteristic (ROC) curves and the areas under the curves (AUCs) were calculated to assess the performance of these models in predicting esophageal varices. Results RPR, GPRI, S-index, FIB-4 and APRI in the severe group were higher than those of the mild and moderate group and non-varices group (all P < 0. 05); and no significant differences were found in the above indexes between the mild and moderate group and non-varices group (all P > 0. 05). The AUCs of RPR, GPRI, S index and FIB-4 in predicting esophageal varices were respectively 0. 902, 0. 828, 0. 960, 0. 883 and 0. 799; AUCs of RPR, GPRI, S index and FIB-4 in predicting severe esophageal varices were respectively 0. 891, 0. 782, 0. 836, 0. 816 and 0. 762. Conclusion RPR, GPRI, S-index, FIB-4 and APRI in the non-invasive serum models are of clinical value in assessing the presence and severe degrees of esophageal varices in patients with alcoholic liver cirrhosis and can be used as the non-invasive assessment methods. [ABSTRACT FROM AUTHOR]