Abstract： Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.