In spite of a great number of published papers on the clinical treatment of portal hypertension, some controversies still exist. The role of propranolol for the elective treatment is not established as the prospective trials have shown conflicting results. The vasoconstrictive drugs associated or not to vasodilating ones have an efficacy comparable to that of balloon tamponade. As to the prophylactic use of propranolol, few papers have been published, but three prospective randomized trials showed that the drug is superior to the placebo, particularly in patients without ascites.