Abstract： @@ As a rare disease aortoenteric fistula (AEF) has a high mortality rate and emergency operation may be effective in some patients. 1-3 Since the classical triad of abdominal pain, pulsatile mass and gastrointestinal bleeding can be seen only in a small number of patients, AEF is hard to be diagnosed. 4,5 We present a case of primary AEF complicated by esophageal ulcer, which was diagnosed one month after the onset of gastrointestinal hemorrhage.