Introduction 
Gastrosplenic fistula (GSF) is a rare entity characterized by an abnormal communication between the gastric cavity and the spleen. Reported etiologies of GSF are splenic or gastric malignancies, splenic abscess, crohn’s disease, peptic ulcers disease, sickle cell disease, sleeve gastrectomy and abdominal trauma1,2. Diffuse large B cell lymphoma (DLBCL) is the most common malignancy resulting in GSF1,2. Predominant symptoms at clinical presentation are abdominal pain, hematemesis, melena, and constitutional symptoms such as generalized weakness, fever and weight loss. Imaging findings of air bubbles and leakage of oral contrast from gastric cavity into the spleen is diagnostic of GSF3. Prognosis and short-term survival in patients with GSF are good (up to 82%) in patients presented without gastrointestinal bleeding (GIB)4. A small proportion of patients with GSF may present with life-threatening GIB. We present a case of GSF secondary to type V gastric ulcer associated with upper GIB.