Esophagogastric fundal varices are serious. The condition can be controlled with standardized and effective treatment. Without active treatment, hemorrhage may occur, resulting in a life-threatening condition. For less severe varices, if left untreated, there is a risk of progression to more severe varices and an increased risk of gastrointestinal bleeding. More severe fundal varices appear endoscopically as serpentine tortuous bulges with reddish coloration, which are prone to hemorrhage, and if left untreated may result in shock or even death. Fundic varices are usually due to portal hypertension, and a common cause is the decompensated stage of liver cirrhosis. Active treatment of the primary disease is needed, such as improving liver function, reasonable diet, active antiviral therapy such as entecavir and antifibrotic therapy such as compound turtle shell soft liver tablets. Esophagogastric fundus varices can be effectively prevented from hemorrhage by sclerotherapy and varicose vein ligation. In addition, surgical treatment such as portosystemic shunt is also feasible for blood diversion, but it is easy to induce or aggravate hepatic encephalopathy. Intravenous intrahepatic porto-corporeal stent shunt should be considered within 72 hours in patients with major bleeding or low estimated success rate of endoscopic treatment. Regular review of gastroscopy is also needed, which can assess the rate of varicose vein progression and control the condition promptly when it occurs. In daily life, it is necessary to maintain a reasonable diet, avoid overwork and sudden exertion, avoid eating hard food, and keep the bowels clear. Medication should be taken according to the doctor’s prescription.