A ligature and suture device for medical application that ligatures or sutures biomedical tissue that has been suctioned by a suction device using a suturing member. The ligature and suture device includes an insertion portion having a lumen into which an endoscope can be inserted, and a distal end portion that is connected to the lumen and in which at least one side aperture is provided, at least one hollow needle that is able to support inside itself the suturing member, and that is placed inside the insertion portion such that a tip of the hollow needle is able to move between a first position, which is on a base end side of the side aperture, and a second position, which is on a distal end side of the side aperture, an operating section that performs an operation to move the needle, and at least one pledget that can be penetrated by the needle, and that is placed in a vicinity of the distal end of the side aperture so as to be freely removable from the distal end portion.