Portal hypertensive colopathy (PHC) is a gastrointestinal complication of portal hypertension. There is a large discrepancy between previous studies regarding prevalence of portal colopathy and its correlation with other factors. The aim of this study is to evaluate the prevalence and factors affecting colonic mucosal changes in patients with liver cirrhosis and portal hypertension. Sixty six patients with liver cirrhosis and portal hypertension(PHT) underwent upper gastrointestinal endoscopy as well as a full length colonoscopy to detect portal colopathy. PHC was diagnosed endoscopically by the presence of diffuse hyperemic mucosa, vascular ectasia, and rectal varices. Biopsies were obtained from the rectosigmoid area as well as from any abnormal mucosal lesions apart from angiodysplastic areas.Results: Diffuse hyperemia, angiodysplasia and rectal varices were found in 64.2%, 40.9% and 13.6% of patients respectively. While hemorrhoids were seen in 54.5%.No significant correlation occurred between severity of PHC and worsening of child classification. In the current study none of the following parameters (grades of oesophageal varices, presence of gastric varices and severe congestive gastropathy) had significant correlation with PHC. No statically significant correlation between the presence and severity of PHC and previous history of variceal injection sclerotherapy or band ligation. Colonoscopic features of PHC were significantly associated with the histopathological diagnosis revealing 94.4% sensitivity and 30.8% specificityConclusion; PHC is a frequent finding in cirrhotic patients with PHT. Colonoscopic features suggestive of PHC were in concordance with histopathological evidence, rectal varices are an important cause of lower GIT bleeding