Portal hypertension, is a relatively rare but extremely dangerous disease. Depending on the cause of portal hypertension, it can be categorized as prehepatic, hepatic and posthepatic. In the pediatric age, most of the cases belong to prehepatic portal hypertension caused by portal spongiform degeneration. The cause of portal spongiform degeneration is not fully understood, and various congenital or acquired causes can result in portal vein obstruction and portal spongiform degeneration. After the formation of portal hypertension, under the body’s self-regulation, many varicose collateral veins are formed to divert portal venous blood flow to relieve portal venous pressure, the most important of which is the esophagogastric fundus collateral circulation. The esophagogastric fundus is a necessary route for food to pass through. Due to the high pressure and thin wall of the submucosal varicose vein, it is very easy to rupture and bleed under the action of food stimulation and other triggering factors, which will then cause gastrointestinal hemorrhage, that is to say, vomiting of blood, pulling black bloody stools, and in severe cases, shock will occur, or even death. Children who recover after rescue treatment may have recurrent episodes of the disease, seriously affecting their quality of life and safety. Portal hypertension is a difficult and complex disease to treat, and in the past it was thought to be fundamentally incurable. The traditional surgical methods include flow-disconnection and shunt surgery, which simply means ligating and disconnecting the bleeding varicose veins or shunting the blood to other parts of the body to reduce the pressure in the portal vein. However, these methods are only symptomatic treatments with a high recurrence rate, and, even if the symptoms are relieved in the long term, the quality of life can be greatly affected due to problems such as portal hypertension gastroenteropathy and hepatic encephalopathy. The Rex procedure involves grafting a segment of one’s own blood vessel between the root of the superior mesenteric vein and the left branch of the portal vein. The bridging vessel crosses over the obstructed segment of the portal vein, like a footbridge over an impassable canyon, and restores portal blood flow to a physiologic state. As a result, not only will the portal pressure be significantly reduced, but blood flow will be restored to the liver, which previously had an insufficient blood supply. Theoretically, this is a radical surgical method to cure the root cause. It has been proven to be effective in clinical practice, and after the Rex procedure, rebleeding can be avoided, liver function improves, and the body’s development gradually returns to normal. The procedure is complicated and difficult to perform, and only a few large hospitals in China can perform it. We hope that this procedure will benefit more children with portal hypertension and give them hope for a better life.