The aim of this audit was to monitor the effects of the introduction of a protocol for the management of acute upper GI haemorrhage and a teaching programme for House Officers in Ninewells Hospital Dundee. All patients admitted to hospital with a history of acute haematemesis or melaena were included in the study and purpose designed audit forms were completed on all patients. Following an initial six month audit period the protocol and teaching were introduced. A further six months audit was then performed. A total of 310 patients were audited over the two six month periods. The results suggest that the introduction of a management protocol and training, in conjunction with a policy of active endoscopic intervention may reduce the number of out of hours emergency endoscopies and the need for emergency surgery.