We report the case history of a 75-year-old female patient suffering from extensive gastric antral vascular ectasia (watermelon stomach) with portal hypertension in alcoholic liver cirrhosis. Iron deficiency anaemia, due to chronic blood loss from the antral lesions, required repeated transfusions. Conservative treatment failed, but a surgical intervention (antrectomy) was discarded in view of concomitant diseases. Endoscopic laser photocoagulation therapy with a Nd:YAG-laser eradicated the characteristic antral lesions, which was accompanied by a significant reduction of transfusion requirements. No relapse has been observed since then. Endoscopic laser photocoagulation appears to be an efficacious and safe alternative in the treatment of gastric antral vascular ectasia.