Abstract Visceral artery aneurysms are rare, with an estimated incidence of 0.1–2%, most frequently involving the splenic artery (approximately 60%), followed by the hepatic artery (around 20%). Among hepatic artery aneurysms, extrahepatic involvement is the most common, and the right hepatic artery is the vessel most frequently affected. Hepatoenteric fistulas secondary to hepatic artery pseudoaneurysms are exceptionally uncommon but may result in life-threatening gastrointestinal bleeding. We report the case of an 86-year-old woman who presented with a four-day history of hematemesis, melena, and hematochezia with clots. Physical examination revealed pallor, asthenia, and tachycardia. Upper gastrointestinal endoscopy demonstrated active bleeding in the first portion of the duodenum associated with a duodenal ulcer. Contrast-enhanced computed tomography identified a saccular pseudoaneurysm arising from the right hepatic artery and protruding into the gallbladder bed. Surgical exploration confirmed an enteroarterial fistula between the pseudoaneurysm and the duodenum. The patient was successfully treated with ligation of the hepatic artery and duodenal exclusion with Billroth II reconstruction. This case highlights a rare but severe complication following laparoscopic cholecystectomy and emphasizes the importance of maintaining a high index of suspicion in patients presenting with unexplained upper gastrointestinal bleeding.