Objective To investigate the efficacy of sclerosing agent combined with ligation in the treatment of esophageal and gastric variceal bleeding, and the influence on hemodynamics. Methods The data of 158 patients with esophageal and gastric variceal bleeding who were treated in the hospital from January 2020 to December 2021 were retrospectively analyzed. According to different treatment methods, the patients were divided into control group (113 cases) and observation group (45 cases). Patients in the control group were treated with ligation, and patients in the observation group were treated with sclerosing agent injection on this basis. Clinical efficacy, hemodynamics, rebleeding rate, recurrence rate and complications were observed. Results The treatment response rate in the observation group (97.78%) was higher than that in the control group (86.73%) (P<0.05). There was no significant difference in CVP between the two groups (P>0.05). The observation group had lower PVP than the control group at T1 and T2 (P<0.05). The rebleeding rate, recurrence rate and the incidence of complications in the observation group (2.22%, 4.44% and 4.44%) were lower than those in the control group (17.70%, 16.81% and 18.58%) (P<0.05). Conclusion Sclerosing agent combined with ligation is effective in the treatment of esophageal and gastric variceal bleeding, which can effectively improve hemodynamics