Portal vein tumor can be diagnosed based on the patient’s symptoms and signs, combined with auxiliary examinations. Most patients with portal vein tumor have no obvious clinical symptoms. Some patients may have abdominal pain or gastrointestinal bleeding if there are serious complications such as tumor rupture, thrombosis and compression of surrounding organs. Ultrasound examination of portal vein tumor is simple, accurate and specific, and is the first choice for diagnosis of portal vein tumor. It can visualize the enlarged and thickened portal vein, and it can also clearly show the state and direction of colorful blood flow, and it can also observe the main trunk of the portal vein, or one or more branches of the portal vein, with limited cystic dilatation. Angiography, abdominal enhanced CT and MR can be used as auxiliary examinations for portal vein tumor. The presence of portal vein tumors can be determined by the presence of the above symptoms and ancillary tests. The presence of portal vein tumor can be determined by the combination of the above symptoms and ancillary investigations, which should be followed by active medical treatment.