Colonic varices are rare complications seen in patients with cirrhosis, and only a few case series have been reported in the literature. In the present article, the diagnostic and therapeutic approach to colonic varices was reported based on clinical features of 6 patients manifesting massive hematochezia. Contrast-enhanced CT revealed that portal vein thrombosis was present in all patients, while colonic varices were seen only in 2 patients. In the remaining 4 patients, colonic varices were confirmed by endoscopic examination done referring to the portal venous hemodynamics on thin-sliced contrast-enhanced CT images. Endoscopic examinations were done in 5 patients, and red dot signs were found on the varices in 4 patients. Of these 4 patients, 3 patients received endoscopic variceal ligation (EVL), while 1 patient was given distal pancreatectomy. Thus, colonic varices merit consideration as a cause of lower gastrointestinal bleeding in cirrhotic patients with portal vein thrombosis. Moreover, the usefulness of EVL should be further investigated.