*Purpose: Area Deprivation Index (ADI) has been utilized as a granular measure of local socioeconomic status for nearly two decades. This study is the first to investigate the relationship between ADI and patient survival after adult liver transplantation.

*Methods: We performed a retrospective study using the cohort of adult liver transplant recipients at the University of Washington Medical Center from Janurary 1, 2004 through December 31, 2020 (n = 1602). Primary exposure was ADI in a range of 1 -100 as determined by the patient’s home address. Primary outcome measures were patient survival and hospital length of stay.

*Results: In a multivariable Cox proportional analysis, patients from high deprivation areas (scores 61 – 100) had a 1.44 hazard ratio (95% CI: 1.06 to 1.96, p = 0.02) for post-transplant death compared to those from lower deprivation neighborhoods (scores 1 – 60). Recipient race was not a significant factor in post-transplant survival. Also, ADI was associated with longer post-transplant length of stay. For each 1-point increase in ADI, the post-transplant hospital length of stay increased by 0.05 days (0.004 to 0.10 day, p = 0.04).

*Conclusions: Adult patients from high deprivation areas have worse survival following liver transplantation and longer hospital stays. Ongoing work is needed to understand the challenges facing transplant recipients from areas of socioeconomic deprivation.

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