To compare the efficacy of endoscopic paravaricenl sclerotherapy and oral propranolol in the prevention of recrvrent upper gastrointeetinal bleeding, 78 cirrhotic patients were randomly assigned to either treatment after endoecopically proven bleed from emphageal varices. After randomieation, but before treatment had been started, a total of eight patients had to be withdrawn from the study due to early rebleeding (requiring emergency sclerotherapy) or violations of the protocol. Among the 70 patients analyzed (36 sclerothemapy, 34 propranolol), both treatment groups were comparable with reepect to demographic, clinical and laboratory data. The groups also did not differ with respect to continued alcohol intake. Sclerotherapy was performed twice weekly using 1% polidocanol as the scleroeing agent until the varices were eradicated or well-covered by fibrous tissue. Propranolol was given twice daily at a dame reducing the rerrting heart rate by 26% (80 to 320 mg per day; mean f SD = 161 f 80 mg per day). Patients were followed for up to 2 years with visits at 3 monthly intervals (mean follow-up = sclerotherapy, 14 monthe; propranolol, 9.2 months). Life table analysis of patients without rebleeding from nonvariceal sites revealed a tendemcy in favor of propranolol; however, the difference did not reach statistical significance. No significant difference was observed between sclerotherapy and proprrrndol in the proportion of patients rebleeding from e a m p b g d varices or from all sources of upper gaitrointertiarrl bledhg. Furthermore, survival was similar in both trerrtaaent groups. A small esophageal perforation due to ~~letrotbrapy was observed in one patient, and one ~~a p n n o l o l patient had to diecontinue the m d c atian due t o severe bradycardia. Other complications of s c l e r o t h e ~~y and side effecte of propranolol were minor. Prupranolol reduced variceal size significantly within 3 months of treatment. No such deereglle was obaerved in a mbgroup of patients who rebled under propranolol, and in the untreated control group of an ongoing trial of prophylactic sclerotherapy. W e conclude that propranolol and sclerotherapy are of compa-