Objective: To compare the short-term clinical efficacy of hand-assisted laparoscopic (HAL) and open modified Sugiura procedure on patients suffering from portal hypertension. Methods: From January 2011 to March 2012, 56 patients with portal hypertension scheduled for a Sugiura procedure were randomly designated to HAL group or open surgery group, with 28 cases in each group. The intra- and postoperative variables between the two groups were compared. Results: Operations were performed successfully in all the patients in the two groups, and no complications developed during the procedures. The differences in operative time and incidence of postoperative complications between the two groups showed no statistical difference (both P>0.05). However, HALS group was better than open surgery group in terms of incision length, intraoperative blood loss, time to have flatus passage, volume of abdominal drainage, and postoperative hospital stay, and all the differences between them had statistical significance (all P<0.05). The patients were followed up for 1 to 13 months, with an average of 7.32 months. The rate of varicose veins occlusion achieved 100% in both groups, and no relapsing bleeding occurred in any of the patients. Conclusion: The HAL modified Sugiura procedure has not only the same clinical efficacy as the open procedure, but also has the minimally invasive advantages of the laparoscopic procedure.