A prospective randomized study was conducted to compare the efficacy of long-term endoscopic sclerotherapy vs. propranolol in Child class B and C patients with variceal bleeds within the 30 days before the stub. Forty-five and 46 patients were randomized to r d v e sclerotherapy and propranolol, respectively, after preentry stratification for Child scores. Sclerotherapy was administered with 1% polidocanol at 1O-day intervals until obliteration of varices was achieved. Propranolol was administered to achieve a reduction in resting pulse rate of 25%. Rebleeding occurred in 19 patients undergoing sclerotherapy and in 31 receiving propranolol (p < 0.05). The number of epieodes of mbleeding was higher (p < 0.06) in the propranolol group (n = 64) than in the sclerotherapy group (n = 35). The mean bleeding risk factor, number of hospitalizations for rebleeding and blood transfusion requirement were also significantly higher in the propranolol-treated patients. The median bleed-free period was more than 36 m o in the sclerotherapy group and 2.5 mo in the propranolol group (p c 0.01). The median survival time was dgni6cantly longer in the sclerotherapy group ( > 36 mo) than in the propranolol group (>24 mo). We conclude that in decompnsated cirrhotic patients, long-term endos c h c sclerotherapy is superior to propranolol in preventing rebleeding and improving survival. (HEPA-