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Introduction: Since esophageal varices ble-eding have highest mortality rate, the prog-nosis of the patients may be worsen if it is accompanied by other injuries. This study evaluated the esophageal varices synchro-nization with different lesions and their rel-ationship with the diameter of portal vein during endoscopy procedure. Materials & Methods: In this cross-secti-onal study, 123 patients who were admitted to gastrointestinal section of Imam Reza and Sina hospitals with esophageal varices underwent endoscopy procedure due to various reasons such as controlling the eso-phageal varices bleeding by ligation band during 2005-2009. The presence of simult-aneous gastric and duodenal lesions was evaluated by endoscopy. Portal vein diame-ter was measured by ultrasound and the re-sults were analyzed. Findings: Most of the patients (63.4%) had grade II varices followed by grade III (26%), grade I (7.3%) and grade IV (3.3%), respectively. The mean of portal vein dia-meter was 12.28±2.59 mm. No relationship was observed between the degree of esoph-ageal varices and portal vein diameter. Als-o, no correlation was seen between the end-oscopic findings appearance of esophagus, stomach or duodenum and portal vein size. Discussion & Conclusion: The results of this study showed that portal vein diameter is not a suitable criterion to evaluate the simultaneous presence of esophageal varic-es along with gastric and duodenal lesions. However, further studies are needed to confirm this finding.