Introduction: On diagnosis upper gastrointestinal (UGI) bleeding is managed early, with saving of 9 of 10 patients. This study was carried out to establish the etiology, comorbidities and clinical status of a patient at the presentation in and thereafter for a month of upper gastrointestinal bleed. Materials and methods: This was a hospital-based prospective observational study, with patients presenting with history of acute ‘upper gastrointestinal bleeding’ (UGI) taken as the inclusion criteria between October 2016 to January 2018 in the study. Results: This study included 125 patients in the inclusion criteria; incidence of acute upper GB was 3.5 per 1000 admissions in the Acute Medical Care per year. The age of patients ranged from 19 to 82 years; the mean age in the present clinical study was 49.51+/- 15.39 years. Males outnumbered females by a ratio of 4.43:1. Most common presenting complaint was melena (48.8%), followed by hematemesis with melena (31.2%). Drug-induced increased risk of UGI bleeding was present in 25% of the patients. History of alcohol intake was present in 28.8% patients; while, 22.4% patients were smokers. The patients with UGI had mostly O+ve blood group with the total 30.4%. On analysis of the results Peptic ulcer and esophageal problems were the most common and second most common causes of UGI bleed; Majority patients were with massive hematemesis and esophageal varices. Re-bleeding within 30 days was seen in 11 patients and most of them had esophageal varices; the mortality rate was 5.6%. Conclusions: Acute UGI was mostly seen in older patients with peptic ulcer disease and esophageal varices as the common causes. Age ≥ 65 yr, SBP < 90 mmHg, heart rate > 100 bpm and low hemoglobin level at presentation were associated with the observed bad outcomes.