Hepatorenal syndrome (HRS), a functional renal failure associated with severe liver disease, is believed to result from diminished effective arterial volume and altered renal hemodynamics. Death is almost inevitable after its development and therapeutic options are limited. Surgical shunts carry an increase in morbidity and mortality, and peritoneovenous shunts are frequently complicated by infection and coagulopathy. We report a case of hepatorenal syndrome successfully treated with transjugular intrahepatic portosystemic shunt (TIPS). This is an unusual therapeutic option for HRS and may lead to future indications for TIPS.