The usefulness of color Doppler sonography for the assessment of intrahepatic hemodynamics and shunt patency was evaluated in a total of eight patients in whom the intrahepatic hemodynamics before and after transjugular intrahepatic portosystemic shunt (TIPS) could be serially examined by color Doppler sonography. In six of these patients the serial sonographic examinations could be followed for more than one year after TIPS creation. Within one month after TIPS creation, Vmax in the shunt was ranged from 87 cm/sec to 242 cm/sec (mean: 142.5 cm/ sec), and the flow direction in the right anterior portal vein was reversed in all patients. More than 70% stenosis of the shunt could be diagnosed by color Doppler sonography. When the shunt was confirmed by angiography to be more than 70% stenotic or occluded, Vmax in the shunt was decreased to less than 50 cm/sec and the blood flow in the right anterior portal vein become hepatopetal. From three months before stenosis or occlusion of the shunt, it was confirmed that Vmax in the shunt was less than 70 cm/sec or the blood flow of right anterior portal vein was hepatopetal. Color Doppler sonography was useful for the assessment of intrahepatic hemodynamics, and shunt patency and prediction of shunt stenosis or occlusion following TIPS creation.