Abstract: Objective To study the clinical features and treatment of regional portal hypertension (RPH). Methods Clinical data about 45 RPH patients admitted to our hospital from January 2008 to June 2012 were retrospectively analyzed. Results Of the 45 patients included in this analysis, 39 (86.7%) were diagnosed with RPH which was resulted from pancreatic diseases and 6(13.3%) were diagnosed with RPH which was resulted from non-pancreatic diseases.The patients were manifested as primary disease, gastrointestinal bleeding, splenomegaly, hyperslenism, and normal liver function.Abdominal ultrasonography, CT, MRI, angiography, gastroscopy, barium contrast radiography, and intraoperative exploration contributed to the diagnosis of RPH.Of the 45 patients, 21 underwent endoscopic injection with tissue adhesive, 21 splenectomy combined with pericardia devascularization, and 2 splenectomy only.The short-and long-term outcomes of surgery were better than those of endoscopic treatment. Conclusion The diagnosis of RPH can be established according to its medical history, clinical features and auxiliary examination.Splenectomy plus pericardia devascularization is the first treatment of choice for RPH.