We present a case of a 34-year-old woman who underwent liver transplantation and developed refractory ascites. Following a prolonged work-up she was diagnosed with anastomotic site stricture of the portal vein. The patient underwent percutaneous angioplasty with balloon dilatation and stent placement, with resolution of the ascites. We review the literature and discuss the etiology of posttransplant refractory ascites and its treatment.