To explore the clinical effect of endoscopic ligation combined with somatostatin in the treatment of liver cirrhosis complicated with gastrointestinal bleeding. Method 102 patients with liver cirrhosis and gastrointestinal bleeding who were admitted to our hospital from February 2020 to March 2025 were selected as the research subjects. The patients were divided into the control group and the observation group by random number table method, with 51 cases in each group. The control group was given endoscopic ligation, while the observation group was treated with somatostatin on the basis of the control group. The hemostatic related indicators (stable blood pressure Time, hemostasis Time, hospital stay, rebleeding rate within 72 hours), hemodynamics (portal vein blood flow, splenic vein blood flow), and coagulation functions [Thrombin Time (TT), Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT), Fibrinogen (FIB)], hemoglobin level and adverse reactions of the two groups were analyzed and compared. Results: The time of stable blood pressure, hemostasis time, hospital stay and rebleeding rate within 72 hours in the observation group were significantly lower than those in the control group (P < 0.05). There was no significant difference in blood transfusion volume between the two groups (P > 0.05). After treatment, the portal vein blood flow and splenic vein blood flow in both groups were significantly lower than those before treatment, and the portal vein blood flow and splenic vein blood flow in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, DE TT, PT and APTT in both groups were significantly lower than those before treatment, and FIB was significantly higher than that before treatment. Moreover, TT, PT and APTT in the observation group were significantly lower than those in the control group, and FIB was significantly higher than that in the control group (P < 0.05). After treatment, the hemoglobin levels in both groups were significantly increased compared with those before treatment, and the hemoglobin level in the observation group was significantly higher than that in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Endoscopic ligation combined with somatostatin treatment can shorten the time of stable blood pressure, hemostasis time and hospital stay in patients with liver cirrhosis and gastrointestinal bleeding, reduce the rebleeding rate within 72 hours, improve hemodynamics and coagulation function, increase hemoglobin level, and has good safety.