Portal hypertension is a frequent and severe clinical syndrome, which almost invariably complicates liver cirrhosis, and is responsible for its clinical consequences, such as gastroesophageal varices, ascites, hepatorenal syndrome, hepatic encephalopathy, bacteremia, and hypersplenism. In recent years with invasive and noninvasive diagnostic methods and in medical and interventional radiology therapies, basic and clinical research allowed significant advances in the knowledge of molecular basis and mechanisms leading to portal hypertension. This review focuses on hot topics in the field of portal hypertension, from pathophysiology to treatment.