Objective To evaluate the impact of splenic vein-left adrenal vein shunting on prehepatic portal hypertension caused by cavernous transformation of portal vein in young patients.Methods From June 2004 to February 2012,9 patients with prehepatic portal hypertension due to cavernous transformation of portal vein received splenic vein-left adrenal venous shunting.The clinical data were reviewed.Results The procedure was uneventful in all the patients.There was no mortality,recurrent hemorrhage or hepatic encephalopathy on follow-up.The patients were discharged home on the 7th postoperative day.Conclusions In young patients with prehepatic portal hypertension secondary to cavernous transformation of portal vein,the left adrenal vein was often found to be large.Spleno-adrenal shunting,utilizing the left adrenal vein as a conduit,represents an excellent option in selected cases.