A male baby, born at 29 weeks with a birth weight of 1.2kg,at week 4, he presented with recurrent hematemesis and melena, leading to shock. Treatment included repeated blood transfusions, octreotide infusions. An upper GI endoscopy revealed a Dieulafoy’s lesion in the first part of the duodenum. Local injection of epinephrine 1:1000 failed to prevent recurring bleeding.Forty-eight hours later, a second endoscopy with a GIF XP190 video-gastroscope was performed and targeted APC (30W, 1L/m) was applied to the lesion, successfully stopping the bleeding without recurrence.Our case is the only reported instance of successful endoscopic management of a duodenal Dieulafoy’s lesion in the duodenum in a preterm baby with very low birth weight.