Objective To investigate the clinical efficacy of applying indirect energy measurement system (namely the calorimetric metabolic cart, CMC) in nutritional therapy for patients with liver diseases. Methods From August 2020 to January 2021, a total of 178 patients with liver disease were divided into a CMC group (n=90) and a routine group (n=88) using random number table method. According to the resting energy expenditure (REE) monitored by CMC (the CMC group) and the basal energy expenditure (BEE) calculated by Harris-Benedict equation(the routine group), corresponding nutritional treatment was given to each group. Serum prealbumin and serum albumin were measured on the 10th day of treatment period. Results On admission, REE values varied significantly by age groups or genders; REE values in each age group had significant differences with BEE values （P<0.05,P<0.01). Ten days into nutritional treatment, serum albumin (171.32±11.24) mg/L and serum albumin (37.65±2.11) g/L in CMC group were significantly higher than those in the routine group ［(129.52±12.31) mg/L and (33.46±2.27) g/L, respectively］(P<0.01). Conclusion Nutritional treatment plan determined according to the energy expenditure measured by CMC can better improve nutritional index of patients with liver diseases.