Budd–Chiari syndrome (BCS) is a rare vascular disorder characterized by obstruction of hepatic venous outflow, which may occur at the level of the hepatic veins, the inferior vena cava, or both. This obstruction leads to hepatic congestion, portal hypertension, and progressive liver dysfunction. The etiology of BCS is multifactorial, with hypercoagulable states such as myeloproliferative neoplasms, antiphospholipid syndrome, and inherited thrombophilias (e.g., factor V Leiden, protein C/S deficiency) being predominant contributors. Geographic variations influence the underlying causes, with membranous obstruction of the inferior vena cava being more common in Asian populations. Clinically, BCS presents with a spectrum ranging from asymptomatic hepatomegaly to fulminant hepatic failure. Diagnostic evaluation includes Doppler ultrasonography, cross-sectional imaging (CT/MRI), and hemodynamic studies. Management follows a stepwise approach: anticoagulation, interventional radiology procedures (e.g., transjugular intrahepatic portosystemic shunt), and surgical options such as portosystemic shunting or liver transplantation in refractory cases.