To evaluate the diagnostic value of endoscopic ultrasound‑guided fine needle aspiration (EUS⁃FNA) for portal vein tumor thrombus, data of patients with digestive system malignant tumors combined with portal vein tumor thrombus diagnosed by CT or magnetic resonance imaging who underwent EUS‑FNA from April 2015 to July 2020 in the Second Affiliated Hospital of Soochow University were collected. A total of 7 patients were included, with 2 cases of primary hepatocellular carcinoma, 3 cases of primary pancreatic carcinoma and 2 cases of primary gastric cancer. EUS⁃FNA was successfully performed in 7 patients with portal vein embolus. Pathological examination of portal vein embolus showed 5 cases of malignant tumor. No tumor cell was found in 2 cases. There were no complications such as local hematoma, abdominal hemorrhage or infection in all patients. EUS⁃FNA is safe and effective for patients diagnosed as having malignant tumors with portal vein embolus.