Twenty-three patients with Budd-Chiari Syndrome were examined by laparoscopy. The characteristic findings were a purple to dusky-blue lobulated surface of the liver, which was covered with whitish bead-like cysts and newly formed tortuous dilated veins. The rich network of blood vessels was also visible over the falciform ligament and peritoneal surface in the majority of patients. Ascites and splenomegaly were an added although nonspecific diagnostic feature.