Although portal vein system thrombosis is a common complication after splenectomy, the extensive portal vein system thrombosis (PVST) is rare. The experience of management and treatment of multiple portal vein thrombosis is worth sharing. We report a 23-year-old female patient with autoimmune liver cirrhosis, failed to give effective anti-coagulation in time to prevent thrombosis, and appeared serious extensive PVST. After the failure of anti-coagulation with heparin, the patient was successfully treated by percutaneous trans hepatic catheter-directed thrombolysis. As far as we know, there is no English case report of extensive portal vein thrombosis in the context of splenectomy for autoimmune liver cirrhosis.