Splanchnic vein thrombosis (SVT) represents an unusual manifestation of venous thromboembolism. The etiological factors for SVT can be divided into local and systemic, frequently found concurrently. SVT can be the first presenting symptom in myeloproliferative neoplasms. SVT puts the patients affected in jeopardy of developing the intestinal infarction, impairing the liver function and portal hypertension development with the risk of potentially life-threatening gastrointestinal bleeding. The current guidelines emphasise the role of anticoagulation in acute splanchnic thrombosis. Considering the potentially fatal complications it is necessary to tailor the anticoagulant treatment individually. The duration of anticoagulant therapy is strongly dependent upon the risk evaluation of thrombosis recurrence. The article deals with the causes, diagnostic methods and aspects influencing the therapeutic strategy.Key words: anticoagulation - liver cirrhosis - portal hypertension - prothrombotic state - splanchnic vein thrombosis.