The recently developed Doppler flowmetry system that consists of an electronic sector and a pulsed Doppler flowmeter, is capable of determining the direction of blood flow in large veins visible by ultrasonography and measuring blood flow. It is noninvasive and can be performed in patients on ambulatory basis at the time of routine ultrasound examination. In this communication, clinical utility of pulsed Doppler flowmetry was tested in 20 patients with portal hypertension. Doppler flowmetry proved useful in differential diagnosis of splenorenal shunt and cystic disease, diagnosis of arterioportal shunt, diagnosis of portal vein occlusion, demonstration of hepatofugal flow in the splenic vein, and prediction of esophageal varices by the demonstration of hepatofugal flow in an enlarged left gastric vein.