A 55-year-old woman with cirrhosis due to primary biliary cholangitis was admitted in the setting of acute decompensation (ascites and hepatic hydrothorax) caused by portal vein thrombosis. Fifteen days after admission, she presented melena and an esophagogastroscopy was performed. Non-bleeding large esophageal varices were identified along with two gastric polyps, both with recent bleeding stigmata. One polyp, with 20 mm, was in the gastric fundus, while the other, a pseudo-pedunculated inflammatory type polyp with 35 mm and multilobulated, protruded from the posterior antral wall into the duodenal bulb. The first polyp was removed with a diathermic loop, after adrenalin injection (1:10.000). However, immediate oozing bleeding occurred, and persisted after scar closure with 4 trough-the-scope (TTS) clips. A metallic “tulip-bundle” technique, using an over-the-scope-clip, was successfully used as a rescue therapy, after a failed classic tulip-bundle using an endoloop in retroflexion. The second polyp was pulled into the stomach using a foreign body forceps, and the “ligate-and-let-go” method was applied; biopsies had been performed. At the end of the procedure, a deep mucosal laceration in the lesser curvature from barotrauma was identified and successfully closed with 8 TTS clips. The patient remained stable during and after the procedure and adjunctive therapy with a proton pump inhibitor was instituted. The histological analysis of the removed polyp revealed high grade dysplasia with focal lamina propria invasion; the ligated polyp was classified as inflammatory. No rebleeding occurred on the two months of follow-up.