Background/Aims: The efficacy of misoprostol was evaluated in patients with esophageal varices bleeding or ascites caused by liver cirrhosis. Methods: The effects of misoprostol on portal hypertensive patients were observed in two groups, a group of 30 patients receiving misoprostol and a control group of 30 patients receiving conventional treatment. We detected ascites with abdominal ultrasonography and compared the misoprostol-diuretics group with the cluretics only group for ascites control. Hemodynamic condition after the administration of misoprostol was observed by measuring changes in volume and velocity of blood flow in portal vein using pulsed Doppler ultrasound. We also made comparisons between the misoprostol only group, EVL-misoprostol group and conservative group for esophageal varices rebleeding episodes during the follow up periods of 6-9 months. Results: In 14 of 18 cases (77.8%), the increase in the velocity and volume was observed and in the remaining 4 cases (22.2%), either a reduction or no change was observed. We observed the effect of misoprostol on ascites in two groups; one group receiving a combined treatment of misoprostol and diuretics, the other group receiving diuretics only. There was a statistically significant effect in the combined treatment group (P<0.05). The recurrence of bleeding after treatment was observed for 6 to 9 months. Rebleeding from esophageal varices occurred in 1 of 12 cases (8.3%) in the misoprostol group and 4 of 13 cases (30.7%) in the non-misoprostol group (P<0.05). However, there was no recurrence of bleeding in 10 patients who were treated with endoscopic variceal ligation and misoprostol during the follow up period. Conclusion: Misoprostol might be a very useful agent in the control of ascites and the prevention of rebleeding of esophageal varices caused by liver cirrhosis. (Korean J Gastroenterol 1996; 28:798-805)