Portal hypertensive gastropathy has been related to portal hypertension and is a recognized cause of iron deficiency anemia. Although this gastric mucosal lesion has been occasionally described in extrahepatic portal hypertension, its clinical significance and histological features are not well established. We report a case of chronic anemia due to portal hypertensive gastropathy in a patient with splenic vein thrombosis, and suggest that the cure of gastric lesions in this condition may be obtained by splenectomy.