Portal hypertension is a complication seen in patients with liver cirrhosis and is characterised by high pressure in the portal vein. As portal hypertension worsens, varices can form, leading to increased morbidity and mortality if these rupture. Bleeding can be prevented with pharmacological agents and endoscopic therapy; however, some patients will experience variceal haemorrhage. Medical and nursing management of acute variceal haemorrhage is key to a successful outcome, and after initial resuscitation, endoscopic therapy should be undertaken. Long-term management to prevent re-bleeding may involve surgery to implant shunts, which aim to reduce portal venous pressure. However, patients often require referral to specialist centres for transplant assessment.