The available pharmacological treatments for portal hypertension are reviewed. Vasoconstrictor treatments include vasopressin (VP), the synthetic VP analogue tGLVP, combined nitroglycerin (NTG)-VP, somatostatin (SRIF), SRIF analogues and non-selective beta-blockers. Vasodilator treatments include short- and long-acting organic nitrates. Infusions of VP > 1.0 U/min can cause severe side-effects. tGLVP can control variceal bleeding and improve survival and causes fewer complications than VP. SRIF is as effective as tGLVP in controlling bleeding and improving survival and has minimal side effects. Beta-blockers are effective in preventing the first variceal haemorrhage and are well tolerated.