ObjectiveTo investigate the predisposing locations of active hemorrhage in patients with esophageal variceal bleeding. MethodsData of 823 patients with acute esophageal and gastric variceal hemorrhage receiving emergency gastroscopy diagnosed from January 2003 to December 2013 were retrospectively studied. The location and site of active hemorrhage or stigmata were analyzed and its relationship with active hemorrhage was discussed. ResultsA total of 372（45.2％，372/823） patients with active bleeding and stigmata were found under emergency endoscopy. Among 372 patients， 190 got accurate hemorrhage and stigmata location and site description. Bleeding or stigmata in 58（30.5％） patients was 28-32 cm from incisor in group A， and that in 132 （69.5％） patients was more than 35 cm in group B （χ2=57.642， P＜0.000 1）. In 190 cases， the proportion of bleeding or stigmata at 3：00 point was the highest（37％，70／132）， followed by those at 12：00 point（30％，58／132），6：00 point（24％，45／132），and 9：00 point （9％，17／132）. The change trend of the percentage of each point in group A and group B was the same as that in all cases. The percentage of almost all points in group B was significantly higher than that in group A except that at 9：00 point （P＜0.000 1）.ConclusionEsophageal variceal bleeding in cirrhosis is more common at 3：00 point， 6：00 point and 12：00 point of esophagus， and the high risk area is 35 cm below the incisors.