INTRODUCTION: Upper gastrointestinal bleeding is a common diagnosis with annual incidence of hospitalization reported as 100 per 100,000 individuals. The most common causes are generally recognized to be esophageal varices or peptic ulcer disease. Neoplasm in the stomach is a less common cause, and is usually due to primary gastric adenocarcinoma. The gastrointestinal tract can also be a site of metastases, however malignant melanoma is a relatively rare cause of upper gastrointestinal bleeding, accounting for less than 3% of all severe cases of bleeding. CASE DESCRIPTION/METHODS: A 76-year-old male with a history of coronary artery disease status post drug-eluting stent, ischemic cardiomyopathy, hyperlipidemia and melanoma of the face treated thirty years prior, who presented to the emergency department (ED) with hematemesis and melena for 2-3 days along with progressively worsening dyspnea and fatigue. The patient had recently started aspirin and clopidogrel following cardiac stent placement. Upon evaluation in the ED, the patient's vitals were stable. A physical exam revealed pallor with poor capillary refill. There was no abdominal tenderness. Lab work revealed hemoglobin 5.6, which increased to 7.6 after two units of packed red blood cells, white blood cells 13.3, serum creatinine 1.35, troponin 0.37. The patient was evaluated by gastroenterology who recommended esophagogastroduodenoscopy. The patient was admitted to low level monitoring for continued blood transfusion requirement. DISCUSSION: The patient was initially managed with intravenous volume resuscitation. EGD showed large gastric ulcer with heaped margins along the greater curvature of the stomach with a visible vessel, for which an endo clip was placed for hemostasis. Biopsies were obtained which later revealed to be metastatic malignant melanoma (+S100 and +MART1). Next-generation sequencing was performed demonstrating negativity for BRAF, NRAS, and KIT mutations. Patients with metastatic melanoma to the GI tract have an overall poor prognosis with life expectancy as short as four months. With the rising incidence of melanoma and its subsequent GI metastasis, it is important to recognize metastatic disease early and potentially decrease the chance of life-threatening complications, which may lead to an early death. Approximately 4% of patients with gastrointestinal melanoma are diagnosed prior to death. Evaluation with endoscopy may be a powerful detection technique in patients diagnosed with melanoma and could detect early disease.