A patient suffered from hepatic myelopathy a year and a half ago, unable to walk and with a large spleen. He returned to self-care after two splenic embolizations and has been aggravated again in the last week. The patient’s CT showed: cirrhosis, small portal vein with internal thrombus, formation of collateral circulation, and post-embolization manifestations of splenic embolization. Analysis: The portal pressure is increased after cirrhosis, the portal vein is widened first, and the spleen is enlarged. The enlarged spleen reduces the blood flow of hepatic artery and aggravates liver ischemia, so the progressive enlargement of the spleen forms a vicious circle with the progress of cirrhosis. The increased portal pressure causes damage to the portal vein and the formation of thrombus, the portal vein is thin, the collateral circulation is formed, and the reduction of portal blood supply and the progression of cirrhosis also form a vicious circle. In conclusion: cirrhotic splenomegaly should be treated early to stop the vicious cycle from occurring and developing. Treatment of splenomegaly has the potential to alleviate hepatic myelopathy.