Abstract Background: Budd Chiari syndrome (BCS) is a heterog-enous group of vascular hepatic disorders. Imaging with recent advances in these techniques play and important role in diagnosis and management of cases with BCS. The aim of the current work was to study the clinical effectiveness of venoplasty, without the need of performing a TIPSS procedure, in management of BCS. Aim of Study: The aim of the current work was to study the clinical effectiveness of venoplasty, without the need of performing a TIPSS procedure, in management of BCS. Patients and Methods: Clinically, all patients presented with symptoms of abdominal pain and distention and signs of hepatomegaly and ascites. Results: Clinically, all BCS patients presented with symp-toms of abdominal pain and distention and signs of hepatome-galy and ascites were included. Informed consent was taken from all patients. These cases were managed as follow: Three cases: IVC angioplasty. Two cases: IVC angioplasty and stent. Four cases: Hepatic vein angioplasty. Four cases: Hepatic vein angioplasty and stent.One case: Collateral hepatic vein angioplasty. Conclusion: Budd Chiari patients should have a thorough Doppler examination to assess the presence of a communication between the hepatic vein or their intrahepatic collaterals with the IVC. The presence of this venous communication could allow us to perform a venoplasty with/without stenting and avoid performing unnecessary TIPSS procedure. Venoplasty has a very good long-term outcome in Budd Chiari syndrome.