Esophageal stricture is an uncommon but troublesome complication of endoscopic ligation of esophageal varices. We present a case of severe esophageal stricture after esophageal variceal ligation. The patient was successfully treated by the Sugiura procedure (splenectomy, esogastric devascularization and esophageal transection) and cervical esophago-gastric bypass after repeated dilatation attempts had failed.