Ischemic gastropathy is an uncommon diagnosis due to extensive arterial collaterals that supply the stomach. The mucosal integrity of the stomach is dependent upon this redundant circulation. Hence, its diagnosis is infrequently entertained in patients presenting with an upper gastrointestinal (GI) bleed. Herein, we report a case of a 76-year-old woman with hypertension, hyperlipidemia, and chronic kidney disease on dialysis who developed an upper GI bleed after becoming septic and hypotensive.