Abstract: Objective:To explore the efficiency and safety of endoscopic ligation by painless gastroscopy for treatment of esophageal varices. Methods:Twenty five patients with esophageal varices due to liver cirrhosis were performed 35 endoscopic ligations,10 cases of which received ordinary gastroscopy and 25 cases painless gastroscopy. The respiration,heart rate,blood pressure and blood oxygen saturation were observed during operation; and the patients' tolerance and the surgeon's satisfaction to the performance were investigated after the operation. The liver function and prothrombin time were examined before and 7 days after the operation in all the patients. Results:There were no significant differences with regard to the heart rate,respiration and oxygen saturation between the two groups(P>0.05),but the diastolic pressure and systolic pressure in the ordinary gastroscopy group were higher than those in the painless gastroscopy group during the operation(P<0.05). More satisfactory operating vision was obtained in the painless gastrocopy group than in the ordinary gastroscopy group (P<0.01). There were no significant differences with regard to the alanine aminotransferase, albumin,total bilirubin and prothrombin time before and seven days after the operation between the two groups(P>0.05). The alanine aminotransferase and prothrombin time at seven days after operation were significantly lower than those before operation in the painless gastroscopy group; the alanine aminotransferase at seven days after operation was significantly lower than that before operation in the ordinary gastroscopy group. Conclusions:Endoscopic esophageal varices ligation by painless gastroscopy is safe and easy to be accepted by patients and surgeons.