OBJECTIVE: To study the treatment of hepatic vein occlusion type of Buga syndrome. METHODS: Fifty patients with hepatic vein type Buga syndrome were admitted from 1995.5 to 2012.2. Among them, 12 cases had proximal hepatic vein occlusion, 6 cases had combined hepatic vein with combined inferior vena cava stenosis, 19 cases had total hepatic vein occlusion, and 13 cases had small hepatic vein occlusion. Among them, 3 cases were acute and 47 cases were subacute or chronic. The patients mainly presented with ruptured esophageal variceal bleeding and intractable ascites, which were clearly diagnosed by ultrasound Doppler, CTA or MRA, upper gastrointestinal barium meal, and angiography. The treatments included hepatic veinoplasty in 12 cases, hepatic veinoplasty plus inferior vena cava angioplasty in 6 cases, TIPS in 13 cases, and modified TIPS in 19 cases. The mean follow-up time was 82±46 months. Results: All patients successfully completed the surgical operation. after TIPS or modified TIPS, the portal pressure gradient decreased from 41.23±10.46cmH2O to 12.35±4.67cmH2O, and the portal blood flow velocity increased from 11.2cm/s to 52.16cm/s. The patients’ bleeding was controlled, the ascites Zhe subsided, and the liver function indexes improved significantly. During the hospitalization, there was one case of death due to liver failure and one case of acute obstruction of the hepatic portal shunt. In the postoperative follow-up, 2 cases of shunt stenosis were supported by dilatation, 2 cases of hepatic vein stenosis were re-dilated, and the rest are still under follow-up. Conclusion: Hepatic vein angioplasty and TIPS have good long-term efficacy in the treatment of hepatic vein type Buga syndrome.