Although operative intervention is infrequently required, upper gastrointestinal bleeding (UGIB) is a common reason for general surgery consultation. Patients typically present with coffee ground emesis or frank hematemesis; however, patients with bright red blood per rectum may also be hemorrhaging from an upper gastrointestinal location, which is defined as proximal to the ligament of Treitz. Significant acute hemorrhage may cause hemodynamic instability. The surgical service may provide their expertise in the resuscitation of the unstable patient whether or not an operative intervention is ultimately necessary.