End-stage liver disease is characterized by the development of complications related to portal hypertension. Hepatic venous pressure gradient (HVPG), as an estimation of portal pressure, has been associated to the development of these complications. Most of the data that has been published in this regard is in the context of the development of varices and variceal bleeding. However, HVPG has also been associated to the development or the outcome of other complications of portal hypertension, hepatocellular carcinoma, liver transplantation, and survival. This review analyses the published data regarding the association between the HVPG and the different possible outcomes in cirrhosis.