Portal hypertension is a known consequence of Symmers Periportal Fibrosis(PPF) affecting mostly the young male population at agricultural schemes, presenting in 70% of the cases with variceal bleeding. The Ultrasound features of PPF are well known, however the impact of the Symmers PPF on the portal vein (PV) and the possibility of the development of portal vein thrombosis as the result of the sever portal hypertension & increased viscosity due to high egg load needs to be explored.To assess portal vein patency 800 consecutive cases presenting to the hepatology unit in the period between October 2000 & October 2015 with ultrasonographic proven PPF were studied by Ultrasound means. Portal vein diameter was found to be 1.48±0.3 cm. Presence of PV thrombus was studied by both gray & Doppler scales & was found to be present in 74.4% of the cases. Only 10.3% of the cases had complete thrombosis, with compensatory PV cavernoma. Right portal vein affection was significantly higher than Left PV, while PV confluence had the highest prevalence of thrombosis. Splenic vein & superior Mesenteric vein thrombus was present in 15.0% of the cases. 8.2% of the cases had thrombus calcifications. No significant correlation was found neither between sclerotherapy treatment nor freequency of sclerotherapy & PV thrombosis. We therefore concluded that Periportal Fibrosis is an unrecognized cause of PV thrombosis carrying probably the highest incidence among benign diseases.