The present paper explores current views on the pathological anatomy of the vessels within the portal vascular bed with a specific focus on the gastric varices. In addition, it discusses the mechanisms of hemodynamic alterations in venous circulation among patients with intrahepatic portal hypertension. The emphasis on the condition of the gastric varices arises from a series of unresolved issues that persist regarding surgical strategies and the differentiated selection of various interventions in the context of gastric varices and the risk of bleeding. An understanding of the pathomorphology and hemodynamics of the gastric venous system is considered crucial for the effective treatment of patients with varicose transformation of the gastric veins.Aim. To present current views on the architectural characteristics of the vessels within the portal vascular beds, as well as the pathomorphology of the gastric varices in the context of intrahepatic portal hypertension.