TIPS creation is a therapeutic alternative for the management of portal hypertension derived complications. In small children, however, this procedure is infrequently carried out because of technical difficulties owing to their small size and scarce information on results. This article presents the results of the treatment with TIPS of 8 children weighing under 10 kg for the management of variceal bleeding, along with the description of the procedure which includes unconventional techniques and materials. Technical and clinical success was 100%. Although this is a small cohort of patients, the results obtained suggest this is a safe, technically, and clinically effective treatment alternative for the complications of portal hypertension in this age group.