we have assessed the efficacy and safety of endoscopic LASER therapy following injection of 1:10,000 eplnephrine solution in 36 patients with bleeding peptic ulcers, in whom an exposes vessel or sentinel clot was indentified.1) 15 of 16 patients (94%) with actively bleeding vessels could be controlled successfully by the combined therapy with epinephrine injection and LASER photocoagulation. 2) 30of total 36 patients (83%) with exposed vessels showed no recurrent bleeding within 72 hours after initial treatment with epinephrine injection and LASER ohotocoagulation.3) Among 5 patients with recurrent bleeding after initial treatment, the bleeding of 4 patients (80%) could be controlled by second trial.4) Ultimately, 34 of total 36 patients (94) with exposed vessels could be managed successfully by the combined treatment of epinephrine injection and LASER photocoagulation. 5) Complications related to LASER therapy follwing epinephrine injection were sepsis in a patient with deabetes melitus, and arterial spurtings in three patients which were successfully controlled by repeated LASER photocogulation.6) The overail morality in this study was 6% (2 patients); one seath was caused by sepsis, and the other was due to underlying hepatocellular carcinoma. In conclusion, the LASER therapy following epinephrine injection may be an effective and safe treatment of bleeding peptic ulcers with exposed vessels in the hemostasis and prevention of recurrence.