Portal hypertension represents a key moment in the dynamic course of chronic liver disease. It is defined as permanent increase of portal pressure above 12 mmHg. The authors discuss the pathological-anatomical consequences of intrahepatic portal hypertension and subsequent haemodynamic changes which may be helpful in explanation of liver parenchyma functional disturbances. Modern imaging techniques are helpful in detection of portal hypertension consequences such as portal-caval anastomoses, arterial-portal anastomoses, predominance of arterial supply and other morphological abnormalities. Hyperkinetic circulation, reduced portal flow, changes of gastric and lienal circulation and other humoral and neural factors represent the introductory pathophysiologic mechanisms of cirrhotic clinical manifestation. We try to evaluate these pathological changes with the help of modern biochemical, imaging and endoscopic investigations in order to assess the degree of parenchymatous damage, the degree of portal hypertension, with certain probability the course and the prognosis, the risks of haemorrhage from esophageal varices, e.t.c. The understanding of clinical manifestations pathomechanisms in cirrhosis is necessary for further development of new investigation methods and improvement of existing imaging and endoscopic techniques. (Fig. 6, Ref. 33.)