Hepatic vena cava syndrome (HVCS) is a bacterial infection induced obliterative disease of inferior vena cava (IVC) at the site of hepatic veins opening that cause chronic liver disease with high incidence of liver cirrhosis and moderate incidence in hepatocellular carcinoma. HVCS manifest clinically as recurrent mild jaundice and/or mild elevation of transaminases or ascites from hepatic venous out flow obstruction. Long term follow up of a large cohort of patients seen over several years showed that 16% had mild splenomegaly and 50% of these developed cytopenia commonly thrombocytopenia and/or leucopenia, a condition called hypersplenism. Development of hypersplenism was related to recurrent or prolonged AEs of HVCS. And it resulted in increased incidence of ascites and cirrhosis and complications like hepatic encephalopathy and gastrointestinal or mucosal bleeding and mortality in the disease.