The aim of this work is to evaluate the role and accuracy of the gray scale and CDUS in differentiating benign from malignant portal vein thrombosis particularly detecting arterial signal within the thrombus in malignant case. Our study shows that sensitivity, specificity, positive and negative predictive values of CDUS in differentiation between benign and malignant PVT was 80%, 100%, 100% & 57.1% respectively.