The peritoneovenous shunt of LeVeen can be safely performed under local anesthesia in patients with advanced cirrhosis and ascites. The technique described was satisfactory in 25 patients. The shunt is effective in relieving dietary, diuretic resistant ascites in selected patients. The rapid, downhill course of the patient with severe hepatic encephalopathy or coma is probably unchanged by the presence of the valve. Surviving patients (18) discharged with shunts in place are under continuing study.