To assess the value of "left gastric vein shunt index" (LGVSI) in the esophageal varices using color Doppler sonography, 32 variceal patients who had large varices(large varices group), 20 patients who had small or medium varices (small or medium varices group), and 15 control subjects were examined with color Doppler sonography. The results showed that the LGVSI in the large varices group was significantly higher than that in the small or medium varices group and in control subjects (P < 0.01). When the best cut-off value of the LGVSI was 0.12, its sensitivity and specificity were 90.6%, 90.0% respectively. Our results suggest that the LGVSI is a useful Doppler ultrasound parameter in evaluating severity of esophageal varices.