This retrospective analysis studied the records of 564 consecutive patients admitted to Gastrointestinal Bleeding Unit of Riyadh Medical Complex with acute upper gastrointestinal bleeding over a 2-year period (May 1996-April 1998). The purpose of the study was to analyze the mortality with an aim to identify the risk factors affecting mortality in these patients. Majority of patients were men (82%) and Saudis (54%). Their mean age was 52.46 + 17.8 years. Esophageal varices (45%) were the main causes of bleeding followed by duodenal ulcers (24%). Overall mortality in this series was 15.8% (89 patients). Comorbid diseases were responsible for death in 68 (76%) patients, whereas, bleeding was considered to be directly responsible for death in 21 (24%) patients. On analysis of data from this study, old age (>60 years), systolic pressure < 90 mm Hg on admission, comorbid disease, variceal bleeding and Child's grade C in patients with chronic liver disease were associated with adverse outcome.