Hepatic encephalopathy is one of the common complications after transjugular intrahepatic portosystemic shunt (TIPS), with a high incidence of about 16% to 55%, with varying reports at home and abroad. TIPS is an interventional procedure for the treatment of upper gastrointestinal bleeding and portal hypertension in cirrhosis.The causes of hepatic encephalopathy after TIPS are related to the following factors. 1. after porto-corporeal shunt, the portal blood enters the body circulation directly without going through the liver for detoxification, thus increasing ammonia in the intestinal metabolites. 2. When blood does not pass through the liver, blood flow to the left and right lobes of the liver is reduced, and hepatic nutrients are reduced, which can also induce hepatic encephalopathy; 3. amino acids from protein breakdown are oxidized to ammonia, and blood ammonia increases with protein intake. 4. constipation can cause ammonia-containing substances to remain in the intestines for a long time, promoting ammonia absorption in the body. 5. Infections, electrolyte disorders, and the use of sedative drugs can induce hepatic encephalopathy. After TIPS, hepatic perfusion is reduced, and harmful substances not detoxified by the liver enter the body circulation directly. Therefore, hepatic encephalopathy can be prevented by restricting protein intake, keeping the bowel clear, preventing infections, and using drugs carefully. Early identification of potential predisposing factors and high-risk factors and active treatment and intervention by nursing staff can reduce the incidence of hepatic encephalopathy and improve the outcome of TIPS surgical treatment.