Obscure GI bleeding is defined as recurrent bouts of acute or chronic bleeding for which no definite source has been discovered by routine endoscopic and x-ray contrast studies. We describe the clinical course and management of 19 patients seen for obscure GI bleeding from November, 1990 to December, 1994. Diagnostic work-up included endoscopy, barium contrast studies, visceral angiographies and bleeding scans. There were 11 males (57%), and 8 females (43%). Mean age was 56 years old (range of 30-88 yrs.). Six patients presented with melena, 7 with hematochezia, and 3 with hematemesis. In 9 patients, the diagnosis was established: 2 had typhoid ileitis, 2 had small intestinal ecchymosis, 1 had an A-V malformation, 1 had adenocarcinoma of the small intestine. In 10 patients there was no diagnosis. Pushenteroscopy had 100% yield. There was an average transfusion requirement of 10 units of blood per patient. Seven patients (36%) required surgery while close observation was done on remaining 12 patients. There were 4 mortalities. Patients had a mean hospital stay of 11 days. In the majority of patients with obscure GI bleeding, the diagnosis is difficult to establish.