Variceal hemorrhage is one of the most common and serious complications of cirrhosis and occurs directly as a consequence of the development of portal hypertension. The onset of this complication in a given patient heralds a worsening in the clinical condition which often progresses to death. The treatment of portal hypertension is therefore an important component of the management strategy in patients with cirrhosis. Ideally, such treatment should be universally effective, safe, easy to administer, widely available, and relatively inexpensive. Unfortunately, none of the existing treatments comes close to being ideal, and the treatment of portal hypertension continues to remain one of the greatest challenges in the management of the cirrhotic patient.