Bleeding related to endoscopic biopsies is relatively uncommon and tends to be a self-limiting process. This article aims to identify those groups of patients that are at a higher risk at the time of the pre procedural evaluation, and to review the current guidelines regarding high risk patients (with special consideration for those who are anticoagulated). It also reviews current strategies for diagnosis, initial evaluation and management of a post procedural bleed. These include all the tools in an endoscopist's armamentarium (thermal, mechanical and chemical) for local control, as well as a discussion about the more severe bleeds that might require interventional radiology or salvage surgery.