Clinically significant portal hypertension is a cornerstone in cirrhosis's natural history, significantly impacting these patients' morbidity and mortality. Unless adequate preventive measures are implemented, the recurrence rate of bleeding can reach up to 65% of patients and with mortality of 57%. The goals in portal hypertension treatment focus on reducing the hepatic venous portal gradient, both by reducing portal blood flow and intrahepatic resistance. Nonselective beta-blockers and esophageal varices ligation have been the standard of care in esophageal varices' treatment. Currently, statins and carvedilol role in reducing portal pressure, preventing esophageal variceal bleeding, and other advanced liver disease complications seem to be promising.