Abstract: Cirrhosis is a severe disease caused by chronic inflammatory damage to the liver due to various factors, often complicated by portal hypertension. The primary causes of portal hypertension include increased intrahepatic vascular resistance and increased portal venous blood flow. Carvedilol, a third-generation non-selective beta-blocker (NSBB) with alpha-1 receptor-blocking role, is superior to traditional NSBBs in reducing portal pressure. It is believed that carvedilol significantly reduces hepatic venous pressure gradient (HVPG) through multiple mechanisms, prevents variceal bleeding, and extends patient survival. This paper reviews the mechanisms and clinical applications of carvedilol in the treatment of portal hypertension, focusing on its efficacy in the primary and secondary prevention of varices and its impact on the survival of cirrhotic patients with refractory ascites.