Objective To analyze the clinical characteristics of pancreatic portal hypertension (PPH) and idiopathic portal hypertension (IPH) .Methods The clinical data of 18 PPH and 36 IPH cases were analysed.Results The liver size and liver function tests such as ALT, AST and GGT were normal and viral indexes were negative in both groups.Ultrasound examination revealed splenomegaly, dilation and tortuosity of spleenic vein.The diameter of portal vein and superior mesenteric veins were wide in IPH whereas, normal in PPH.There were pancreatic diseases such as pancreatitis and tumor in PPH patients.Portal area fibrosis and inflammatory cell infiltrations were seen in patients with IPH whereas histopathology was normal in patients with PPH.Conclusion IPH and PPH should be considered when portal hypertension patients are presented with normal liver function and normal liver size in clinical practice.Ultrasound examination of portal vein, superior mesenteric vein and pancreas is important to provide definite diagnosis.