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Introduction: The role of elective or emergency surgery in portal hypertension is coming down worldwide due to the availability of excellent endotherapy facilities. In India these facilities are confined to some major centers only in big cities. Hence surgical treatment had to be undertaken both for elective and emergency situations with excellent results in non-cirrhotic patients who are seen in large numbers in India with absolutely normal livers.Aim: We prospectively evaluated the results of surgical treatment in patients with extra-hepatic portal venous obstruction and non-cirrhotic portal fibrosis.Materials and methods:Over a twelve-year period we performed surgery in 64 patients with non-cirrhotic portal hypertension. Age ranged from 8 years to 57 years. 33 patients had proven extra-hepatic portal venous obstruction and 31 had non-cirrhotic portal fibrosis. 47 patients underwent proximal spleno-renal shunt procedure with a splenectomy and 17 patients underwent splenectomy with devascualrisation. Majority of patients had evidence of hypersplenism.Results: Surgery was successful in all patients. Mean blood requirement was less than one unit. Pancytopenia improved in all the patients. With a follow-up of 12 years, 8 patients presented with upper GI bleeding and all of them settled with endotherapy. None developed encephalopathy or liver failure.Conclusion: In the Indian subcontinent, where non-cirrhotic portal hypertension with normal livers is seen quite often and where uniform availability of good endotherapy facilities is not there all over the country, surgical treatment is an excellent one-time option with good results.