OBJECTIVE To investigate intestinal permeability in patients with portal hypertension and its relationship with portal pressure. METHODS Twenty patients with portal hypertension were divided into two groups (A, B), 10 patients per group. In group A, patients were treated with combined transjugular intrahepatic portosystemic shunt (TIPS) and modified Sugiura. In group B, patients were treated with modified Sugiura only. Intestinal permeability was assessed before operation, two weeks after TIPS, and two weeks after modified Sugiura; 20 healthy control subjects were also assessed. RESULTS Intestinal permeability was significantly higher in the patients than in the control group (P<0.01). In group A, portal pressure, intestinal permeability decreased two weeks after TIPS (P<0.05), and no obvious change was noted two weeks after modified Sugiura; but they were significantly lower than those before TIPS (P<0.05). In group B, intestinal permeability was not different before and after operation. Intestinal permeability in group A was not different from that in group B before treatment, but significantly lower after modified Sugiura (P<0.05). Portal pressure was significantly correlated with intestinal permeability (r=0.627, P<0.01). CONCLUSIONS This study shows that combined TIPS and modified Sugiura can lower portal pressure and intestinal permeability, and enhance the therapeutic efficacy on portal hypertension.