It has been emphasized repeatedly that the immediate death rate is extremely high in cirrhotic patients having massive esophageal hemorrhage (Refs. 3, 8, 11, 13, 15, 18, 21, 24, 27). Therefore, to repeat this assertion with still another review of cases would seem superfluous. However, it is our opinion that the story has only half been told—that in the light of present surgical attempts to control the situation, the entire implication is not fully appreciated—and that the assertions of surgical triumphs over this condition should be tempered with some of the thoughts here expressed. This review was originally undertaken to evaluate our results in the treatment of hemorrhaging cirrhotic patients. We could not believe our experiences were as bad as those of others. The review proved to be a monotonous repetition of what: had already been reported. It indicated an unbelievably high mortality immediately following the first massive hemorrhage, with