Abstract From March 1979 to April 1988 nine patients with hepatic cirrhosis have presented with acute variceal haemorrhage from gastric varices. Of six patients who underwent emergency laparotomy those with modified Child's grade C (n = 3) died within 30 days of surgery. Six patients have been followed for 2 years or longer. In the three patients who underwent under-running of gastric varices alone, two patients developed oeosophageal varices at 3 and 14 months, respectively, and in the third patient gastric varices recurred 3 years after surgery. In the remaining three patients, additional left gastric vein ligation was not associated with recurrence of gastric varices or the development of oesophageal varices.