In a 72-year-old female patient suffering from non specific and vague abdominal pain, an aneurysm of the portal vein was discovered. In the absence of complication, and because the risk of operation appeared too high, the decision was to abstain from surgery. With more than 3 years of regular follow-up, the patient was free of symptoms, and the portal vein aneurysm was unchanged. Sixty cases including this one are reviewed.