Introduction: Small bowel bleeding is an uncommon cause of gastrointestinal (GI) haemorrhage and remains the most obscure source due to the inherent difficulty in localisation, frequently necessitating multiple diagnostic modalities. Common aetiologies include vascular lesions, ulceration, and neoplasia, particularly in the elderly. Case: A 77-year-old female presented with melaena and profound symptomatic anaemia (haemoglobin 28 g/L). Her background included poorly differentiated serous carcinoma of gynaecological origin, diagnosed following open anterior resection for sigmoid stricture. She had completed three cycles of carboplatin and paclitaxel chemotherapy and was awaiting radical hysterectomy and bilateral salpingo-oophorectomy. Despite extensive investigation with computed tomography angiography, digital subtraction angiography, upper and lower endoscopy, push enteroscopy, and capsule endoscopy, the bleeding source remained unidentified. Ongoing haemorrhage necessitated exploratory laparotomy with intraoperative enteroscopy. Four morphologically similar small bowel ulcers were identified and managed with endoscopic adrenaline injection, gold probe coagulation, and surgical oversewing. Histopathological analysis of ulcer biopsies demonstrated no malignant or inflammatory pathology. Discussion: This case demonstrates a rare presentation of non-specific small bowel ulceration resulting in life-threatening haemorrhage. It highlights the role of surgically assisted enteroscopy in cases of obscure gastrointestinal bleeding refractory to conventional endoscopic and radiological investigation, enabling definitive localisation and haemostatic control through combined endoscopic and surgical techniques. References: 1. Gunjan D, Sharma V, Rana SS et al. Small bowel bleeding: a comprehensive review. Gastroenterol Rep. 2014;2(4):262–275. 2. Onyirioha K, Balakrishnan M. Hemorrhagic gastropathy from paclitaxel–carboplatin combination chemotherapy. ACG Case Rep J. 2025;12(8):e01780.