Objective: To investigate the clinical effect of selective devascularization and combined devascularization operation for portal hypertension. Methods: Two-hundred and forty-seven patients with portal hypertension admitted to our hospital from June 2009 to December 201 were designated into two groups according to their operative procedures, namely, the selective devascularization group (126 cases) and combined devascularization group (121 cases). The clinical data of the patients before and after surgery, and the clinical efficacies between the two groups were compared and analyzed. Results: The free portal pressures (FPP) of the patients in both groups were decreased significantly after surgery (both P<0.05), and the FPP in selective devascularization group decreased more significantly than that of the combined devascularization group (P<0.05). Except for the Child-Pugh score, the other indexes that included the incidence of postoperative recurrent hemorrhage, hepatic encephalopathy, portal venous thrombosis and portal hypertensive gastorpathy as well as degree of gastroesophageal varices of the selective devascularization group were all better than those of the combined devascularization group (all P<0.05). Conclusion: Selective devascularization is an ideal surgical procedure for portal hypertension because it is of favourable efficacy with fewer complications.