Distance from the hepatocaval junction (HCJ) to the hepatic venous (HV) end of transjugular intrahepatic portosystemic shunts (TIPS) created with bare-metal stents (BMS) has been shown to impact patency. Now, most TIPS are created with polytetrafluoroethylene (PTFE)-covered stent-grafts. This study investigates the impact of the distance from the HCJ on patency of PTFE-covered TIPS. PTFE-covered TIPS placed between 2002 and 2016 were retrospectively reviewed. Clinical and imaging data were collected from the electronic medical record and radiology imaging archive. Distance from HV end to the HCJ was recorded using the post-TIPS placement venogram performed with a calibrated marker catheter for reference. Primary patency rates were calculated. Differences between groups based on distance from HV end to HCJ were compared using Kaplan-Meier and Cox regression analyses. Of the 413 PTFE-covered TIPS placed during this time period, 393 had images available to evaluate distance from HV end to the HCJ. 278 TIPS were placed with a single stent-graft while 115 were extended at the HV end with additional stents. TIPS with a HV end flush with the HCJ had 1 and 2-year primary patency rates of 79% and 72% compared to 76% and 70% for TIPS whose HV end did not terminate at the HCJ (p = 0.88). For alternate thresholds of <5, 10, or 15 mm from HV end to HCJ, p-values for Cox regression analyses were 0.87, 0.47, and 0.39 respectively. In TIPS created with a single stent-graft, 1 and 2 year primary patency rates were 80% and 77% compared to 73% and 61% for those using multiple stents (p = 0.043; HR1.57, CI1.02-2.42). When the HV end of a PTFE-covered TIPS is within 15 mm of the HCJ, primary patency rates of all TIPS are similar. TIPS created with multiple stents are associated with lower primary patency rates than those created with single stents. Thus, when creating a PTFE-covered TIPS, extending the HV end of TIPS is unnecessary if a single stent is within 15 mm of the HCJ.