Background: Blue Rubber Bleb Nevus Syndrome (BRBNS) is a rare venous malformation. Endoscopic diagnosis and therapy have evolved significantly, yet evidence from Latin America remains scarce. Retrospective case series of adults diagnosed with BRBNS and managed at a tertiary Mexican center between 2010–2025. Results: Four patients presented with multifocal gastrointestinal involvement. Small intestine was the most affected segment. All patients required endoscopic therapy: cold snare (n=57), EMR (n=25), detachable snare (n=22), cyanoacrylate injection (n=10), and APC (n=1). There was no mortality or major adverse events. All patients met clinical response criteria during a median follow-up of 36 months. Conclusions: Multimodal approach constitutes a safe and effective strategy for the endoscopic management of BRBNS.