Objective To examine the efficacy of endoscopic variceal ligation (EVL) as a secondary prophylaxis for cirrhotic patients associated with esophageal varices, and to identify the risk factors for postoperative rebleeding. Methods A retrospective analysis was performed on the clinical data of cirrhotic patients with esophageal variceal bleeding (EVB) in the Peking University First Hospital from 2000 to2012. Patients were divided into ligation and control (conservative treatment) groups and their prognosis was followed up. According to the outcome, the ligation group was further divided into rebleeding and non-rebleeding groups for comparative analysis of clinical data. Continuous data were compared between groups using the independent samples t-test, and data were converted before t-test when necessary.Ranked data were analyzed using the Mann-Whitney U test, and categorical data were compared between groups using the χ2test. Results A total of 139 patients were enrolled, 119 assigned to the ligation group and 20 to the control group. At the end of the follow-up period (1 to 24 months) , the rebleeding, early rebleeding, and mortality rates significantly differed between the ligation and control groups (P<0. 05) , i. e., 41. 2%, 8. 4% and 7. 6% in the ligation group versus 70. 0%, 20. 0% and 40. 0% in the control group, respectively. In the ligation group, comparative analysis showed that the history of hepatic encephalopathy, ascites, Child-Pugh score, and platelet count significantly differed between the rebleeding and non-rebleeding groups (P < 0. 05) . Conclusion As a secondary prophylaxis therapy, EVL can effectively improve the prognosis of cirrhosis associated with EVB. The deterioration of liver function may indicate a higher risk of rebleeding. Therefore, it is necessary to improve patients basic conditions during EVL therapy.