Compared to idiopathic pulmonary arterial hypertension (IPAH), patients with portopulmonary hypertension (POPH) have worse survival. Health disparities may contribute to these differences but have not been studied. We sought to compare socioeconomic factors in patients with POPH and IPAH and to determine whether socioeconomic status (SES) and/or POPH diagnosis were associated with treatment and healthcare utilization. We performed a cross-sectional study of adults enrolled in the Pulmonary Hypertension Association Registry. Patients with IPAH (n=344) and POPH (n=57) were compared. Compared with IPAH, patients with POPH were less likely to be college graduates (19.6 versus 34.9%, p=0.02) and more likely to be unemployed (54.7 versus 30.5%, p<0.001) and have an annual household income below poverty level (45.7 versus 19.0%, p<0.001). Patients with POPH had similar functional class, quality of life, 6MWD and mean pulmonary arterial pressure with a higher cardiac index. Compared with IPAH, patients with POPH were less likely to receive combination therapy (46.4 versus 62.2%, p=0.03) and endothelin receptor antagonists (ERAs) (28.6 versus 55.1%, p<0.001) at enrollment with similar treatment at follow-up. Patients with POPH had more emergency department (ED) visits (1.7±2.1 versus 0.9±1.2, p=0.009) and hospitalizations in the 6 months preceding enrollment (1.5±2.1 versus 0.8±1.1, p=0.02). Both POPH diagnosis and lower education level were independently associated with a higher number of ED visits. Compared to IPAH, patients with POPH have lower SES, are less likely to receive initial combination therapy and ERAs but have similar treatment at follow-up and have increased healthcare utilization.