Objective To explore the clinical value of emergency gastroscopy at different times in high-risk liver cirrhosis patients combine with acute esophageal and gastric variceal bleeding, and seek the best time.Methods 77 cases of high-risk liver cirrhosis combine with acute esophageal and gastric variceal bleeding in our hospital were divided into group A n=28), group B (n=23) and group C (n=26) according to the timing of gastroscopy. Patients undergo gastroscopy within 6 hours after admission in group A, 6～12 hours after admission in group B and 12～24 hours after admission in group C. The average length of stay, amount of average red blood cell transfusion, hospitalization expenses, hemostasis in acute phase, rebleeding, 6-week mortality and the incidence of hepatic encephalopathy were compared among the three groups. Results There was significant difference in the control of acute bleeding and detect the bleeding site among the three groups (P＜0.05). Gastroscopy performed within 6h and 6~12h after admission can improve the detection rate of bleeding site, and gastroscopy performed within 6～12h has higher detection rate of bleeding site and acute hemostasis rate. However, there was no significant difference in hospitalization time, blood transfusion volume, hospitalization expenses, incidence of hepatic encephalopathy, early rebleeding rate and 6week mortality (P＞0.05). Conclusion In order to find bleeding lesions as much as possible and improve the success rate of acute hemostasis, it is recommended that high risk patients should have gastroscopy within 6～12 hours after admission, but more clinical evidence is needed for gastroscopy earlier (within 6 hours).