A total of 194 patients who underwent 235 endoscopic sphincterotomies for common bile duct (CBD) stones were reviewed with respect to bleeding after the procedure. Evidence of bleeding was found in 21, but was occult in 7. Of the 14 patients with overt bleeding, 6 required operation and 2 died. There was also one death prior to surgery. Early consultation with surgical colleagues, observance of the usual surgical criteria for upper gastro-intestinal haemorrhage and the use of non-absorbable suture material to achieve haemostasis may reduce the morbidity and mortality of this complication of endoscopic sphincterotomy.