Background: Esophageal variceal bleeding (EVB) remains a major complication of portal hypertension in patients with liver cirrhosis. Factors that contribute to EVB are any conditions that increase the abdominal venous pressure such as muscular exertion from lifting heavy objects, straining at stool, sneezing, coughing and vomiting. Aim: This study aimed to assess patients' knowledge and perception regarding factors aggravating esophageal variceal bleeding. Design: Descriptive exploratory design was be utilized to answer the research questions. Setting: This study was be conducted at intensive care of hematemesis unit at Alexandria University Hospital. Subjects: The study subject included 70 patients from both genders. Tools: Part (I) Patient's interviewing questionnaire tool: It included the socio-demographic characteristics of patient (age, gender, educational..etc), patients' clinical data such as present and past medical history. Part (II) The assessment of patient's knowledge regarding factors that aggravate EVB. Part (Ш) Patient's perception scales was used to assess patients' illness perception. Results: The results revealed that, the mean age of the studied patients were 51.3± 5.11, 68.6% were males and 100% of them were married. 62.9% had unsatisfactory level of knowledge regarding factors aggravating EVB. 57% of the studied patients had high score perception about EVB, 43% of the studied patients had low score perception about EVB. Conclusion: The study findings concluded that, the most factors which affect esophageal varices bleeding were age, sex, education level, residence, income, history of disease, knowledge regarding esophageal varices definition, causes, aggravating factors, complications, and different management strategies. Recommendations: The study should be replicated on large sample size and in different hospitals setting in order to generalize the result.