OBJECTIVE: To investigate the efficacy and prognosis of gastric coronary vein-portal vein left branch shunt for the treatment of pediatric extrahepatic portal hypertension. Methods Between October 2008 and January 2013, 17 children presented to the hospital with upper gastrointestinal bleeding symptoms such as “vomiting blood and black stools”. Among them, 9 cases were male and 8 cases were female; the average age was 4.9 years. The average age of the children was 4.9 years old, and they were admitted to the hospital with extrahepatic portal hypertension after completing abdominal B-mode ultrasound, enhanced CT and routine blood tests, which indicated portal vein spongiosis, splenomegaly and hypersplenism. All children were treated for extrahepatic portal hypertension with gastric coronary vein-portal vein left branch shunt. 2 children were treated with 2.5 cm coronary vein and 4 cm and 6.5 cm inferior mesenteric vein grafts were used as extension vessels. All children were followed up after surgery for 3-34 months (mean 12 months). During the follow-up period, ultrasonography was used to assess the spleen size and shunt vessel patency. The results of routine blood and blood biochemistry tests were recorded. Results All children were successfully treated with gastric coronary vein-portal vein left branch shunt. Surgical time ranged from 195 to 375 min, with a mean of 250 min. 3 children had 1 unit of homogeneous red blood cells injected intraoperatively, and the rest had no blood transfusion. Hospitalization time ranged from 9 to 22 d, with a mean of 15 d. Postoperative portal venography showed that all the children had smooth shunt vessels. Postoperative blood counts and blood biochemistry results were normal, and follow-up ultrasound showed that the shunt vessels were clear and the spleen was significantly reduced. 2 children had recurrence, and conservative treatment was effective. Conclusion: Gastric coronary vein portal vein left branch shunt is an effective treatment for pediatric extrahepatic portal hypertension.