A short cut review was carried out to establish whether terlipressin should be used in upper GI bleeding when variceal bleeding is not suspected as the cause. 556 papers were found, of which none answered the three part question. The clinical bottom line is that there is no evidence for the use of intravenous terlipressin in patients presenting with acute, severe upper GI bleeds unless they have endoscopic evidence of varices or a high clinical index of suspicion is met.