Eighty percent of hemophiliacs exposed to plasma products are seropositive to hepatitis B and an even higher percentage are seropositive to hepatitis C, Post-transfusion hepatitis is followed by cirrhosis in up to 25% of the cases, In the wake of portal hypertension, the development of oesophageal varices entails the risk of life-threatening hemorrhage. We report on a patient,vith moderate hemophilia A (factor VIII:C 4-11%), who suffered from massive hematemesis, melaena and evolving shock after excessive alcohol ingestion, The diagnosis of Mallory-Weiss syndrome and the differential diagnosis of bleeding oesophageal varices as well as prognostic consequences are discussed.