We analyzed the clinical characteristics of portal hypertensive gastropathy (PHG), focusing on the etiology of portal hypertension, the severity of esophagogastric varices, portal hemodynamics, and investigated the change of PHG after endoscopic therapy or non-shunt operation for varices. PHG was recognized in 208 cases (54.7%) among 380 patients with portal hypertension, and high incidence rates of PHG were found in the circumstances : extra-hepatic portal obstruction, Child's Class C, absence of portosystemic shunt, and hepatofugal or bidirectional blood flow in the left gastric vein. PHG were more frequently present in case with gastric varices alone, and the severe PHG were observed high in cases of high grade esophageal varices (F1<F3). Analysis of clinical outcomes after treatments for varices revealed a tendency for PHG to improve after non-shunt operation. These findings lead to the suggestion that the degree of gastric mucosal congestion is related to progression of PHG, and that increased portal hypertension is associated with the development of PHG. Selection of the appropriate treatment modality should be contingent upon evaluation of hemodynamics and take account of its effects on the gastric mucosa.