A 32-year-old female patient presented to our OPD with a history of left-side abdominal discomfort and bloating sensation of 3 months duration. Physical examination was unremarkable. On further history, she claimed that she was told to have an intraabdominal blood clot elsewhere around 2 years back after presenting with a similar complaint. She was by then started on anticoagulation with warfarin, discontinued it after 6 months (physicians' decision), and was off anticoagulation for the last 1 year. Laboratory investigation revealed raised Bilirubin (TB-1.6 mg/dl and DB-0.9 mg/dl). Other investigations were in the normal range. Ultrasound evaluation revealed liver has a normal echo pattern, while the Portal vein cavernous transformation with splenomegaly (16.5cm). Abdominal CT revealed chronic portal and spleno-mesenteric vein thrombosis with a cavernous transformation of PV and portal biliopathy. Three columns of distended tortuous esophageal varices (Grade III) with PHG were seen upon endoscopy. On our evaluation for the underlying cause, JAK 2 mutation turned positive. Prophylactic EVL was done. Propranolol and warfarin were resumed. She currently is stable with INR in the target.