Background. Esophageal varices bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis.Aim. Assessment of the incidence and risk factors of in-hospital mortality after acute variceal bleeding among cirrhotic patients in upper Egypt.Methods. During six months period between January 2010 and June 2010, 108 cirrhotic patients with bleeding esophageal varices were admitted in Tropical Medicine and Gastroenterology Department, Assiut University Hospital. All patients received vasoactive drugs and endoscopic therapy. Patients mortality was evaluated at 6 weeks. Many independent risk factors of mortality were evaluated.Results. In the 108 patients, the overall mortality was 16.7% at six weeks. Independent risk factors of in-hospital mortality after bleeding esophageal varices were renal failure (OR 5.4, 95% CI 1.237: 23.63), early re-bleeding (OR 0.03, 95% CI 0.003: 0.332), and low serum albumin (OR -0.237,95% CI -0.282: -0.024).Conclusion. Renal failure, early re-bleeding, and low serum albumin were independent risk factors for early death after esophageal varices bleeding among cirrhotic patients