Duodenal varices are a rare and serious manifestation of portal hypertension. Such cases are very rarely seen in the Makkah region of Saudi Arabia and very few other cases have been reported previously. It is essential to do an endoscopic examination of the complete duodenal mucosa to ascertain bleeding from duodenal varices. The available medical management includes vasopressin and endoscopic sclerotherapy, but has been shown to have a less favorable outcome and a high rebleeding rate. Suture ligation or resection has had similar results.  Our management of the case with bleeding duodenal varices stimulated a review of this subject.