Fatty liver itself usually does not cause splenomegaly and portal hypertension, but if fatty liver develops into cirrhosis, it will lead to portal hypertension, which in turn will lead to splenomegaly. It is recommended to go to the hospital to complete the relevant examinations, hospitalization and treatment, and carry out symptomatic treatment for the primary disease and its complications under the guidance of the doctor. If portal hypertension occurs, the treatment methods are: 1. Medications such as vasodilator drugs (nitroglycerin, etc.) to reduce the pressure in the portal vein and its varicose veins. 2. Surgical treatment, including splenectomy and shunt surgery, can effectively control portal hypertension bleeding, but it is not often applied in clinical practice due to the risk of hepatic encephalopathy caused by surgical trauma. 3. Endoscopic sclerosing agent is more commonly used to stop bleeding, or interventional therapy is used to put stent between the portal vein and hepatic vein to let the blood shunt to reduce the pressure of the portal vein. If the symptoms of hypersplenism due to splenomegaly cannot be improved after the above treatments, and even upper gastrointestinal bleeding may occur due to esophagogastric fundal varices, splenectomy may be performed if necessary, but a comprehensive preoperative analysis should be conducted. Removal of splenectomy will alleviate the symptoms but may increase the risk of thrombosis and infections, so a comprehensive analysis of the pros and cons should be conducted. Treatment of related diseases should be carried out under the guidance of a doctor, as well as regular review and prompt consultation if there is any discomfort.