Hepatic portal hypertension is an unusual complication of cancer therapy. The authors report 2 children under the age of 18 months with disseminated neuroblastoma who developed cavernous transformation of the portal vein during chemotherapy. While the older child remains well, the second patient succumbed from overwhelming variceal hemorrhageas a result of this condition. Full recovery of hepatic function is not invariable following the regression of extensive liver in filtration by neuroblastoma and consideration should be given to follow-up Doppler ultrasound imaging of the hepatic portal system in affected infants.