Emphysematous gastritis (EG) was first reported by Fraenkel in 1889, and it is a relatively rare disease caused by gas-producing bacteria with a high mortality rate of 55.3%.Although the exact pathophysiology of emphysematous gastritis remains unclear, it is thought that pre-existing gastric ulcers or ischaemic lesions provide the nidus for bacterial infection, overgrowth and penetration into the gastric wall. The organisms produce gas after the penetration, and finally emphysematous gastritis develops. This uncommon but life-threatening condition is often confused with its relatively benign counterpart – gastric emphysema, which occurs when air enters the gastric wall usually following trauma to the gastric mucosa, and has an excellent prognosis even with no treatment. However in gastric emphysema, there is no associated infection, and patient does not present with acute abdomen.Diagnosis is challenging due to its rarity and nonspecific symptoms, including severe abdominal pain, coffee-ground emesis, fever, and signs of systemic infection. We present a case of a patient with signs and symptoms of EG, where prompt diagnosis and treatment were achieved, avoiding further complications. Surgical intervention was avoided due to the successful response to conservative treatment. These cases highlight the importance of early detection and intervention in improving patient outcomes and preventing complications associated with EG.