Upper gastrointestinal endoscopy plays a major role in the diagnostic and treatment of the complications of portal hypertension in patients with liver cirrhosis. Endosonography (EUS), which combines routine endoscopy and ultrasound examination has been so far infrequently used in these cohort of patients despite the fact that it offers much more detailed analysis of several features of portal hypertension, not detected with routine endoscopy. These include detection of so called "deep varices", assessment of the thickness of gastric wall, differentiation between thickened folds and varices or detection of subclinical amounts of ascitic fluid. In this paper we systematically review the current and potential future applications of EUS in the diagnostic and treatment of patients with liver cirrhosis.