Introduction：Since its introduction in 1986[1], endoscopic variceal ligation (EVL) has gained wide acceptance in clinical practice due to its simplicity, short duration, and low complication rates[2, 3]. Clinical guidelines in many countries have been recommended EVL as the first-line treatment for esophageal varices in liver cirrhosis[4-6]. However, there have been reports of potential adverse events associated with EVL. These include esophageal stenosis, ulcer bleeding, esophageal perforation, esophageal hematoma, pneumonia, and spontaneous bacterial peritonitis[7-10]. Although rare, cases of liver dysfunction following EVL have also been reported. In this paper, we present the case of a 50-year-old male patient diagnosed with alcoholic cirrhosis and esophageal variceal rupture and bleeding. He underwent emergency EVL for hemostasis at our hospital. Subsequently, he developed liver dysfunction. The patient’s condition improved following active conservative treatment in internal medicine and DPMAS+PE therapy.