ObjectiveTo explore an individualized treatment program to prevent the initial bleeding of a patient with cirrhosis and esophageal varices by the methods of evidence-based medicine. MethodsOne patient with cirrhosis and esophageal varices was admitted into our hospital on November 2, 2013. After evaluating the patient's condition adequately, we proposed the problem according to the PICOS principles. Then, we assessed the clinical evidence from the Cochrane Library (1990-2012), Medline (1950-2012), Embase (1991-2012), VIP (1989-2013), and CBM (1990-2013). The individualized treatment plan was made through doctors' experiences and analysis of those high-quality evidences from the databases. ResultsEight studies (randomized controlled trials and 5 meta-analysis) were included. We evaluated a series of associated problems:whether we should take measurement to prevent initial bleeding of esophageal varices; which one (β-blockers or ligation of esophageal varices) was the best method to prevent the initial bleeding based on efficacy, complication and cost-effectiveness. Then, according to the evidences and the patient's view, we gave non-selectiveβ-blocker as the primary prevention. After one-year followed-up, the initial bleeding of the patient did not occur. ConclusionMaking the prevention plan for a patient with cirrhosis and esophageal varices can not only find out the individualized program, but also push the patient to make decision for their own health.