With more widespread application of and improved outcomes from pancreatoduodenectomy, late complications of this procedure are appearing more commonly in the clinical setting. Presented here is an unusual case of hemobilia secondary to cavernous portal vein transformation one year following pylorus-sparing pancreatoduodenectomy. Common and unusual causes of gastrointestinal bleeding following pancreatoduodenectomy are discussed. Copyright (C) 2013, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.