Aim: To evaluate the correlation between disease severity and hepatic dysfunction in patients with dengue viral infection and identify key clinical and laboratory predictors of severity. Material and Methods: This observational, cross-sectional study was conducted over six months at a tertiary care center, involving 100 laboratory-confirmed dengue patients aged 18 years and above. Clinical data, laboratory investigations (including liver function tests, hematological parameters), and physical examinations were collected. Patients were classified based on the 2009 WHO Dengue Guidelines into three severity categories. Hepatic dysfunction was assessed using AST and ALT levels. Results: The majority of patients were aged 31–50 years, with a slight male predominance. Common clinical features included fever (100%), hepatomegaly (40%), and bleeding tendencies (35%). Elevated liver enzymes were present in most patients, with moderate elevation (42%) being most common. A statistically significant correlation was found between hepatic dysfunction and disease severity (p = 0.004). ALT, AST, platelet count, hematocrit, and hepatomegaly were significant predictors of severe dengue in regression analysis. Conclusion: Hepatic dysfunction is significantly associated with dengue severity. Elevated liver enzymes, low platelet count, and hepatomegaly serve as important indicators of severe disease. Timely assessment of these parameters can guide early intervention and improve patient outcomes.