BACKGROUND: Endoscopic ultrasound (EUS) is sensitive for gastric varices, peri-gastric vessels, and ascites in patients with suspected or proven liver disease (e.g. with stigmata of cirrhosis and/or portal hypertension), but the prevalence of these findings in normals (i.e. no clinical suspicion for liver disease) is unclear. AIM: To determine the prevalence of EUS signs of portal hypertension in normals. METHODS: The presence of varices (measurable rounded anechoic submucosal structures), peri-gastric vessels, and ascites was compared in consecutive EUS patients with no history, clinical evidence, or risk factors for cirrhosis (other than possible alcohol [EtOH] consumption). Drinkers were also compared to nondrinkers. RESULTS: 181 pts were studied: 42 drinkers and 139 nondrinkers. Overall, 12% had measurable submucosal vessels, 7% had perigastric vessels, and 5% had at least one small triangle of ascites. Drinkers and non-drinkers did not differ significantly for age (51 vs 61yrs) and race (83% and 83% white) but were significantly more often males (52% vs 35%; P=0.05). Drinkers had peri-gastric vessels and ascites significantly more frequently and showed a non-significant trend towards more frequent varices. CONCLUSIONS: 1) Measurable gastric submucosal vessels, perigastric vessels, and small triangles of ascites may be seen by EUS in normals. 2) The increased frequency of these findings in drinkers as compared to non-drinkers who all have no other clinical evidence of cirrhosis and/or portal hypertension suggests that EUS may be useful to detect gastric changes due to EtOH and/or subclinical portal hypertension.