Portal hypertension is an old problem, but many solutions have been elaborated in recent years, mostly through international cooperation of several research groups. Ultimately, liver transplantation is a solution for all these problems but with the increasing need for liver transplantation and the lack of sufficient donor organs, there is still a high need for better conservative and interventional treatment solutions to portal hypertension. With the rapid improvements in specific therapies for chronic liver disease, especially viral hepatitis, there is hope that there will be a decreasing need for the treatment of the complications of advanced stage liver disease in future years.