Management of the patient with upper gastrointestinal bleeding is a continuing challenge to the gastroenterologist and the surgeon. Endoscopy early in the course of bleeding benefits the patient only when diagnostic accuracy is combined with definitive hemostatic therapy. Effective methods are now available for endoscopic hemostasis of bleeding ulcers and bleeding varices. However, an improvement in the outcome of gastrointestinal bleeding is not easily achieved, since age and the incidence of severe underlying disease in patients with upper G.I. hemorrhage have been steadily increasing over the years.