ABSTRACT
Portal hypertension is a result of interplay of numerous static and dynamic forces. Portal hemodynamic characterization involves pressure and flow studies which in turn estimate portal pressure. Hepatic venous pressure gradient is the gold standard for determining portal pressure. Portal hemodynamic measurement has helped to understand the pathogenesis and prognosis of chronic liver disease and to define clinically important hepatic venous pressure gradients. Management strategies for ascites and prevention of variceal hemorrhage have been influenced by hemodynamic studies in animals and humans. The hemodynamics in non-cirrhotic portal fibrosis is ambiguous. The role of portal hemodynamic studies outside clinical trials needs further study.