A 45-year-old male with a history of alcohol use disorder and chronic Hepatitis C presents to the emergency department with disorientation after being found surrounded by a pool of dark-colored vomitus at home. The patient arrives at the emergency department via ambulance and is found to be in shock. The clinician establishes hemorrhagic shock as the leading diagnosis which is suspected to be secondary to upper gastrointestinal bleeding. The patient is presumed to have cirrhosis based on his past medical history as well as secondary physical exam findings supporting the diagnosis of cirrhosis. The presumed diagnosis of cirrhosis raises the possibility of esophageal varices as the leading cause of upper GI bleeding. The patient is resuscitated with crystalloid as well as blood products. He is treated with supportive treatments for variceal bleeding and ultimately undergoes definitive endoscopic hemorrhage control of bleeding varices.