The results of splenorenal shunt (SRS) in 405 patients were compared with those of simple splenectomy (SS) in 376 cirrhotic patients in the treatment of portal hypertension. The recurrent bleeding rate was 10.12% in SRS group and 21.2% in SS group, respectively (P < 0.001). The mortality of rebleeding was 2.96% in SRS group and 10.6% in SS group, respectively (P < 0.01). Death from hepatic failure developed at 16.5% of SRS patients and at 9.8% of SS patients, respectively (P < 0.01). The rate of postoperative variceal bleeding and mortality in prophylactic SRS group were 4.9% and 6.2%, and 15.1% and 26.4% in prophylactic SS group, respectively (P < 0.01). The authors are in favor of prophylactic SRS and modified side-to-side SRS for its simplicity and good results.