Objective To assess the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with covered stents in patients of gastroesophageal varices bleeding. Methods Clinic data of sixty-eight patients (50 men and 18 women, mean age: 55) of gastroesophageal varices bleeding were analyzed retrospectively from December 2010 to February 2015, in Fujian Medical University Affiliated Union Hospital. The number of patients who had Child-Pugh class A, B, and C cirrhosis were 33, 31, 4, respectively. The portal vein pressure changes after TIPS were analyzed with T test. The cumulative free of variceal rebleeding rate, stent patency rate and survival rate of all patients were analyzed with Kaplan-Meier method. Results All TIPS were technically successful. 115 stents were used, including 68 covered stents and 47 bare stents. The mean portal vein pressure decreased from 42.4 cmH2O to 30.9 cmH2O (t=15.4, P<0.01). All the cases were followed up from 0.1 to 52.3 months with an average of (19.4±16.1) months. During the follow-up, variceal rebleeding occurred in 15 patients (22.1%), and the cumulative free of variceal rebleeding rates were 89.6%, 83.0%, 78.8% and 73.0% at 3, 6, 12 and 24 months, respectively. The cumulative stent patency rates were 95.6%, 93.1%, 76.9% and 72.4% at 3, 6, 12 and 24 months, respectively. The overall mortality rate was 16.2% (n=11), and the cumulative survival rates were 95.6%, 92.5%, 90.7%, 82.2%, 77.9% and 69.2% at 3, 6, 12, 24, 36 and 48 months, respectively. The HE incidence rate was 22.1% (n=15). Conclusions As the treatment of gastroesophageal varices bleeding, TIPS with covered stents is safe and effective.