Endoscope therapy for variceal hemorrhage has evolved significantly since the 1940s. In 1939, Crafoord and Frenckner first reported the use of sclerotherapy for bleeding esophageal varices. In the mid 1940s, however, the portacaval shunting procedure introduced by Whipple diverted attention away from endoscopic sclerotherapy. Over the next 2 to 3 decades, shunt surgery was performed frequently. It was shown to be capable of lowering the risk of recurrent hemorrhage from varices, but it failed to prolong patient survival. In addition, it was associated with undesirable rates of hepatic encephalopathy or hepatic failure, particularly in those patients who already had reduced hepatic reserve.As the shortcomings of shunt surgery became widely known, endoscopic sclerotherapy again emerged as an attractive alternative in the treatment of bleeding esophageal varices. Since the 1970s, endoscopic sclerotherapy once again has been established as the first-line therapy for variceal bleeding (by our groupIn 1986, Steinmann and colleagues (8) introduced a new endoscopic band ligation technique for control of variceal bleeding. This technique is now the endoscopic technique of choice for variceal bleeding.This paper will limit the discussion to sclerotherapy and band ligation.