Objective To evaluate the safety and efficacy of metal clips combined with endoscopic histoacryl injection for gastric varices with spontaneous portosystemic shunts. Methods The clinical data and complications of 32 patients who were treated with metal clips combined with endoscopic histoacryl injection at Beijing Ditan Hospital of Capital Medical University from May 2016 to October 2018 were collected and analyzed. Results Hemostasis was achieved in all patients, and the median volume of histoacryl was 3.8 mL. Varices were eradicated or disappeared in 9 cases, and the degree of varices were lessened in 23 cases. No rebleeding was found at 72 h, 7 d, 14 d and 6 weeks after operation in any patient. No ectopic embolism occurred. Conclusion Metal clips combined with endoscopic histoacryl injection is effective and safe to treat gastric varices with spontaneous portosystemic shunts.