Aorto-enteric fistulas are life-threatening conditions that occur commonly between the aorta and duodenum. Our case describes a fistula between the ileal artery and small bowel. To our knowledge, ileal artery fistulas are more commonly described in surgical cases, unlike our case. This case emphasizes early diagnosis of an aorto-enteric fistula causing life-threatening gastrointestinal bleeding to improve morbidity and survival.