Bulbar ulcer bleeding remains a frequent cause of upper gastrointestinal hemorrhage, although its incidence has decreased with the use of proton pump inhibitors and the eradication of Helicobacter pylori. The aim of this study was to evaluate the correlation between bulbar ulcer topography and clinical severity. This was a prospective analytical study conducted over a 28-month period, from April 2020 to August 2022, including patients admitted on an emergency basis for upper gastrointestinal bleeding secondary to a bulbar ulcer. The use of non-steroidal anti-inflammatory drugs and tobacco consumption were the main identified risk factors. A marked male predominance was observed, and anterior localization of the bulbar ulcer was significantly associated with an increased risk of hemodynamic instability.