Gastrointestinal stromal tumors (GISTs) is a rare stromal neoplasm that represent the most common mesenchymal tumor of the GI tract, accounting for 0.2% of all GI malignancies and 5% of all sarcomas.[1,2] GIST originating from interstitial cells of Cajal, which are regulators of gut peristalsis, are preferentially located in the stomach and the small intestine. It is characterized by indolent clinical symptoms including vague abdominal pain, weight loss, GI bleeding and obstruction, which is caused by the growing tumor. The usual presentation of GIST is a GI bleed. Acute presentation of GIST with features of hemoperitoneum has never been reported. We report an unusual case of small bowel GIST in which the patient presented with GI bleed before presenting as hemoperitoneum.