Portal hypertension is an important pathophysiological link in the development of cirrhosis and one of the important clinical manifestations in the decompensated phase of cirrhosis. Transjugular intrahepatic portosy stemicshunt (TIPS) is one of the key measures to reduce portal vein pressure in cirrhotic patients by creating a shunt tract in the liver parenchyma between the hepatic vein and portal vein in a minimally invasive manner, which significantly reduces portal vein resistance structurally. With proper selection of cases, it can effectively reduce the complications of cirrhosis such as rebleeding of esophagogastric varices and recurrence of ascites, improve the quality of life of cirrhotic patients, and reduce or delay the need for liver transplantation. TIPS has been used in clinical practice for more than 20 years. After a series of exploration of concepts, techniques, devices and combined drug therapy, the effectiveness and safety of the technique are becoming more and more mature, and patients have significantly benefited in terms of survival time and quality, which has been widely recognized by domestic and foreign colleagues. In 2013, the Gastroenterology Interventional Group of the Chinese Medical Association invited some domestic experts in related disciplines to reach a consensus on TIPS for the treatment of portal hypertension in cirrhosis, with the aim of helping more clinicians to apply this minimally invasive procedure in the treatment of portal hypertension in cirrhosis. The incidence of ruptured esophagogastric varices and bleeding (EGVB) in cirrhotic patients is about 30%-70%, and within 1 year after the detection of definite esophagogastric varices, about 30% of patients are at risk of EGVB. 1. Acute EGVB: The morbidity and mortality rate of patients within 6 weeks is about 20%, and resuscitation treatment is required for fatal hemorrhage. On the basis of maintaining airway patency and blood circulation stability, and according to the conditions of each hospital, consider: ① remedial TIPS, which is the second-line option when drug combined with endoscopic treatment fails; ② early TIPS, which is the first-line option for resuscitation within 72h after massive bleeding. Early TIPS has a hemostatic success rate of >95% and is more effective than drug-combined endoscopic therapy in controlling fatal hemorrhage and reducing rebleeding, reducing intensive care and hospitalization time, and significantly improving patient survival. Patients with cirrhosis Child-Pugh grade C, but with a score <13, may benefit more from early TIPS. 2. Secondary prevention of EGVB: After cessation of acute EGVB, patients are at high risk of rebleeding and death. For untreated patients, the average rebleeding rate is 60% within 1-2 years and the morbidity and mortality rate is up to 33%, thus all patients recovering from acute bleeding should receive secondary prophylaxis. Although the rate of variceal rebleeding after TIPS (9.0%-40.6%) is significantly lower than that of drug and endoscopic treatment (20.5%-60.6%), drug and endoscopic treatment is still the first choice for secondary prevention and TIPS is the second-line option due to the lack of adequate clinical study data on the survival rate of TIPS in recent years. （TIPS is the first-line treatment option for refractory ascites, which not only reduces portal vein pressure and relieves ascites, but also improves urinary sodium excretion and renal function, and is superior to laparotomy for relieving ascites and improving survival. (iii) Refractory hepatic pleural effusion TIPS can relieve refractory hepatic pleural effusion and reduce the number of thoracentesis required, but the impact on survival is unclear. Due to the lack of effective measures for refractory hepatic pleural effusions, TIPS is still considered an important treatment for refractory hepatic pleural effusions. (iv) Hepatorenal syndrome (HRS) The median survival time for HRS is only 3 months, including I months for untreated type I HRS. TIPS may improve renal function by increasing renal perfusion and may improve survival in patients with type 2 HRS. (v) Buga syndrome (BCS) BCS is a post-hepatic portal hypertension caused by obstructive lesions of the hepatic venous outflow tract and the inferior vena cava of the posterior hepatic segment from various causes. TIPS is not usually required for short-range occlusion of the hepatic vein or inferior vena cava with high long-term patency rate by balloon dilation or combined stenting. tIPS establishes an artificial shunt through the portal vascular bed to reduce portal pressure and improve liver stasis and liver function, and is suitable for patients for whom medical treatment or angioplasty has failed. (vi) Portal vein thrombosis (PVT) PVT is a common complication of portal hypertension in cirrhosis, the incidence can be as high as 36%, and its mechanism involves the decrease of portal blood flow velocity and imbalance of coagulation function due to portal hypertension in cirrhosis. TIPS can not only open the portal vein, reduce its pressure and increase its flow rate, but also prevent the recurrence of PVT. Contraindications to TIPS 1. Absolute contraindication: unproven portal hypertension in liver cirrhosis. 2. Relative contraindications: ①Child-Pugh score >13; ②renal insufficiency; ③severe right heart failure; ④moderate pulmonary hypertension; ⑤severe coagulation disorder; ⑥uncontrolled intrahepatic or systemic infection; ⑦biliary obstruction; ⑧polycystic liver; ⑨extensive primary or metastatic liver malignancy; ⑩portal vein cavernous lesions.