Caustic ingestion is an important global health problem that is largely underreported. In adults, it is typically associated with suicide attempts, with alcohol or recreational drug use, or in those with other mental health problems. The extent of injury following caustic ingestion depends on the type of product (alkali or acid), the amount ingested, and length of contact time. It is an emergent condition that may lead to serious morbidity, with deleterious complications, and even death. This paper aims to give awareness on the possible complications of such cases; and what may be done. This is to report on a singular case of a 32-year-old, Filipino, female, who intentionally ingested hydrochloric acid, approximately 50ml in volume. She was diagnosed with epilepsy at 12 years old, maintained on Phenobarbital, and had associated developmental delay. She is mainly dependent on her mother and elder sister. An immediate endoscopy was done within 24 hours of ingestion, which showed circumferential erosions and ulcerations throughout the length of the esophagus, and necrotic and friable stomach mucosa (Zargar IIIB). She was maintained on nothing-per-orem, given intravenous hydration, parenteral nutrition and proton pump inhibitor drip. A re-look endoscopy was done after 96 hours post-acid ingestion, which revealed a mid-esophageal stricture at 25cm from the incisors occupying about 10% of the lumen; still with circumferential erosions and friable mucosa throughout the length of the esophagus; the stomach had linear brownish black ulcers in the entire stomach; and the pylorus was distensible and intubated, revealing friable and erythematous mucosa involving the first and second portion of the duodenum (Zargar IIIA). In coordination with the General Surgery service, patient was observed for progressive feeding from liquids to soft diet, which was generally tolerated. Patient was discharged and advised for repeat endoscopy after 2 months post-injury when stricture formation commonly occurs. However, at 5 weeks post-ingestion, patient consulted at the out-patient department due to episodes of post-prandial vomiting following intake of food or liquids. Repeat endoscopy was then advised, which still revealed an esophageal stricture occupying 10% of the lumen, esophagitis LA grade A, and now with a stenotic pylorus with a linear clean-based ulcer. Biopsy taken revealed mucin-secreting columnar epithelium with chronic active inflammation. The duodenum was no longer accessible. Patient then underwent laparoscopic gastrojejunostomy under the General Surgery service, and re-started on progressive diet. With multidisciplinary coordination, patient was stabilized and discharged with ongoing monitoring and rehabilitation. Endoscopy is a reliable technique for assessing the extent of caustic injury and the presence of complications, such as stricture formation and stenosis. These may occur earlier or even years thereafter, and timing is of the essence. Early, and individualized, surgical intervention may also result in excellent long-term outcome for such instances.