Severe intestinal bleeding in elderly patients is associated by an increased risk of mortality. Factors contributory to the poor prognosis are cardiac, respiratory, hepatic and renal diseases. In upper gastrointestinal bleeding initial diagnosis is built up by means of endoscopy in more than 90 per cent. Immediate emergency endoscopy improves the outcome only in patients with active bleeding. In severe lower gastrointestinal bleeding angiography is the primary diagnostic procedure to be performed. Angiodysplasias as a frequent source of lower intestinal bleeding are localized easily by angiography. Conservative therapy of gastro-intestinal bleeding includes endoscopic, angiographic and medical procedures.