Salvage TIPS is indicated in patients with active endoscopically uncontrollable variceal bleeding. TIPS alone is not effective in management of gastric varices and BRTO requires favourable variceal anatomy. Concomittant placement of a TIPS stent with antegrade variceal embolisation leads to control of gastric variceal bleeding with no significant increase in portal pressure. A single centre retrospective observational study where patients with active uncontrollable gastric variceal bleeding were included in the study. Technical success of the procedure, 5-day rebleed, 6-weeks and 6-months survival as well as other additional outcomes were evaluated. A total of 18 patients were included in the study. Technical success was 100% and significant non-target embolisation was seen in 0% patients. 6 week and 6 month survival rates were 66.67% with an overall survival of 108.786 days (censored at 180 days). 5 day rebleed rate was 11.1%. A significant difference in CTP score (p = 0.03), MELD Na score (p = 0.022), requirement of intubation (p = 0.038), hemoglobin levels (p = 0.042), hematocrit value (p = 0.018), PRBC infusion required prior to and after the procedure (p = 0.045, 0.044) and presence of refractory shock (p = 0.013) was observed between the survival and the mortality group. Post variceal bleeding hemoglobin levels, MAP and MELD-Na scores were significant predictors of mortality. TIPS in adjunct to antegrade transvenous embolisation is a safe and effective modality for management of active uncontrolled gastric variceal bleeding in patients with variceal anatomy unfavourable for performing RTO.