Significant gastrointestinal (GI) bleeding in the postoperative period is an uncommon complication of surgery. The management of GI bleeding within the postoperative period is complex because of a larger differential for the source of bleeding and a more complex risk/benefit analysis. There is minimal published literature specific to the management of postoperative GI bleeding, and the infrequency, complexity, and variability of the clinical setting of this complication confound simplistic consideration of its cause and therapy. This article outlines a systematic evaluation of the patient, treatment options, and assessment of risk/benefit ratio for various treatment options.