Treatment choice of hepatocellular carcinoma with portal hypertension YANG Lian-yue, CHEN Guo-dong. Department of Surgery, Xiangya Hospital, Central South University, Changsha 410008, China. Corresponding author: YANG Lian-yue, E-mail：lianyueyang@hotmail.com Abstract Hepatocellular carcinoma with portal hypertension is a complicated condition, which is very difficult and controversial for clinical treatment. The treatment choice should be based on the factors causing portal hypertension, and adopt individualized treatment. Combined procedures are suitable for the patients with permitted condition; those patients who could not tolerate should undergo staging operation; for patients of poor general condition without surgical indication, non-surgical treatment is appropriate in principle. Correct decision-making regarding surgical indications, strict control of intraoperative bleeding and active prevention and treatment of postoperative complications are crucial to treat effectively.