A new method of surgical treatment is described for the Mallory-Weiss tear that is not controlled by conservative measures. This technique uses a team approach combining endoscopy with simultaneous laparotomy to plicate the Mallory-Weiss tear without opening the gastrointestinal tract. We believe this method offers equal or better vision of the lesion than gastrotomy and will significantly lower the morbidity and perhaps the mortality associated with violating the integrity of the gastrointestinal tract.