Upper gastrointestinal bleeding (UGIB) is a common and costly emergency. Mortality from UGIB is around 10%, although 80–85% of patients experience only a single episode. Most episodes are self-limited, and resolve spontaneously. Failure to accurately identify those at high risk for re-bleed may result in significant morbidity and mortality. As a result, many patients are admitted to the hospital at a significant cost. Patients can be stratified based on a scoring system, and can have an early endoscopic procedure. Hydration, proton pump inhibitors, serial hemoglobin/hematocrit measurements, serial orthostatics, radiology studies such as CT scan or CT angiogram, and gastroenterology consult for early endoscopy can be done in the OU.