Purpose : The purpose was to evaluate the procedure-related complications of the TIPS and its clinicalsignificance. Materials and Methods: The materials consisted of 52 patients who had 57 TIPS procedures for themanagement of variceal bleeding due to portal hypertension. To detect the occurrence of complications duringtranshepatic needle puncture(from hepatic vein to the portal vein), contrast material was injected with thewithdrawl of the puncture needle. Results : Procedure-related complications occurred in 28 patients (54%) among 52patients. The complications were biliary tree puncture(15 cases), transperitoneal puncture(14 cases), stentmalposition(3 cases), stent migration(1 case), hepatic arteries puncture(1 case), splenic vein perforation(1case), and paroxysmal ventricular tachycardia(1 case). Three patients had acute stent thrombosis with rebleedingimmediately after the procedure. The procedure were repeated in two patients. One patient was expired due torebleeding. Conclusion: The procedure related complications were clinically insignificant in most instances,except when stent thrombosis or proxysmal ventricular tachycardia was developed.