58 year old male patient presented with hematemesis. He was suffering from systemic hypertension, dyslipidemia. After initial resuscitation, intravenous fluids,  pantoprazole infusion and blood transfusion, he underwent upper endoscopy, which showed an ulcer in the posterior wall of the esophagus with unhealthy margins and fresh blood noted in the lumen. A CT aortogram showed contrast extravasation from descending thoracic aorta into esophageal lumen confirming presence of aorto-esophageal fistula. He underwent cathetar aortogram which showed contrast leak in the descending thoracic esophagus into oesophagus. A fully covered aortic stent was placed in the descending thoracic aorta to control leak. He recovered with medical management and repeat endoscopy after 3 days showed signs of healing. There were no features of malignancy upon narrow band imaging and biopsy on followup.