Pulmonary hypertension is a potentially lethal complication of end-stage liver disease with a prevalence of 2 %. In the setting of liver transplantation, the prevalence may be as high as 12 %. Given the potential importance of this syndrome to the transplantation community, the purpose of this review is to summarize the current state of understanding of portopulmonary hypertension and to suggest potential management strategies for (1) liver transplant candidates with suspected pulmonary hypertension and (2) intraoperative pulmonary hypertension following liver allograft reperfusion.