Ruptured esophageal variceal bleeding is a common cause of upper gastrointestinal bleeding and one of the most serious complications of portal hypertension in liver cirrhosis. Endoscopic variceal vein ligation (EVL) is a new technique and method for the treatment of esophageal varices that has achieved good results. stiegmann et al. first reported EVL in 1986 as a safe, simple and effective treatment for hemostasis and prevention of bleeding based on the principle of elastic rubber band ligation of internal hemorrhoids. The endoscopic ligature is a modification and continuation of a ring ligation technique widely used for hemorrhoids, which can precisely ligate lesions on the mucosal surface of the stomach and esophagus, such as varicose veins and vascular malformations, with a rubber band under direct gastroscopic view. 24 hours after EVL the mucosa and submucosa are ischemic and necrotic; an acute inflammatory response occurs in 3 to 7 days, with a demarcation of the surviving and necrotic tissue and the appearance of granulation tissue; reexamination after 14 to 21 days Gastroscopy showed healing of the ulcer and disappearance of the varices without serious complications. In case of acute bleeding from esophageal varices, the bleeding lesion can be lanced directly under endoscopy. If the bleeding site is not found, spiral ligation is used and all cases of active bleeding or spurting can be controlled without serious complications. EVL is also the preferred method of hemostasis when esophageal variceal bleeding occurs in patients with hepatocellular carcinoma, and in the absence of portal vein cancer thrombosis, EVL significantly reduces the rebleeding rate and prolongs survival.