The portal vein embolism occurs when an embolus completely or partially obstructs the lumen of the portal vein, splenic vein, or superior mesenteric vein. Thrombosis and tumor thrombosis are the most common types. A portal vein thrombosis (PVT) can be caused by a variety of factors, including inflammation, neoplastic factors, coagulation dysfunction, postabdominal surgery, or traumatic causes. PVTT (portal vein tumor thrombosis) results from a lack of connective tissue in the central vein of the liver lobule, which is easily blocked by cancer nodules. There is an abnormal density within the lumen of a portal vein embolus on a plain CT scan. On the enhanced scan, PVT shows high density and there can be calcification. In spiral CT portography, various phases of the liver are scanned one after another, including arterial, portal venous, and delayed phases. In the portal venous phase, 3D vascular reconstruction is done using time segmentation. For detecting portal vein emboli, MRIs are commonly used, as they can not only show the size and location of the emboli but also the peripheral collateral circulation conditions. Diagnosing the condition primarily relies on symptoms and patient history, with a focus on differentiating it from peritonitis with complications of upper gastrointestinal bleeding and intestinal blockage.