We performed transportal coil-assisted balloon-occluded retrograde transvenous obliteration II, a modification of balloon-occluded retrograde transvenous obliteration, for gastric varices due to left-sided portal hypertension. Significant scale-down of varices was confirmed on upper gastrointestinal endoscopy and contrast-enhanced computed tomography at 6 months after intervention. In the meantime, there were no complications related to treatment. We present transportal coil-assisted balloon-occluded retrograde transvenous obliteration II as a new alternative in addition to splenectomy and partial splenic embolization for gastric varices induced by left-sided portal hypertension.