This article covers new endoscopic imaging modalities in nonvariceal upper gastrointestinal bleeding, such as Doppler ultrasound probe technology, endoscopic ultrasonography, color Doppler optical coherence tomography, and magnification endoscopy. A more in-depth discussion of these modalities and the published evidence supporting their use are included. Furthermore, the shift in focus from identification of conventional visual surface stigmata of recent hemorrhage to an assessment and understanding of subsurface blood flow as it relates to the bleeding lesion is discussed.