Seven patients with bleeding esophageal varices secondary to splenic vein thrombosis were studied over the past five years. This infrequently reported condition was apparently caused by pancreatitis in five cases, retroperitoneal Hodgkin's disease in one, and shunt surgery in one. Four of the five patients treated by splenectomy are alive without recurrent hemorrhages from 8 to 60 months after operation. Angiography is the definitive preoperative examination. Splenectomy is the treatment of choice.