Abstract: Liver transplantation is the only effective treatment for portal hypertension (PHT) and end-stage liver disease. However, great therapeutic needs are far from satisfaction due to extreme shortage of donated livers. Good timing and indicator selection for PHT liver transplantation, and appropriate management of complications before or during on the waiting list, can avoid unnecessary liver transplantation and decrease the mortality rate of patients on waiting list. There are some particularities and issues worthy of attention. Understanding these particularities and handling these issues properly are extremely important to increase the success rate of PHT liver transplantation, enhance the recovery after surgery, and decrease the operative mortality.