We report a case of a 53-year-old male with Vibrio cholerae non-O1 (serotype O19) infection, resulting in perforative pan-peritonitis. The patient had a history of gastric cancer and a gastrectomy was performed one year prior. The patient had previously been admitted with nausea and vomiting and was diagnosed with a sub-ileus condition. He was provisionally discharged when his condition improved and during that period he ate raw fish caught locally in Nagasaki Prefecture, and several hours later he experienced a sudden onset of severe abdominal pain and nausea and on diagnosis of pan-peritonitis an emergency resection of the transverse colon was performed. We subsequently isolated Vibrio cholerae non-O1 from the patient's peritoneal fluid and stool. He died of multiple organ failure three weeks later despite intensive chemotherapeutic care and treatment for shock and disseminated intravascular coagulation. The strain of Vibrio cholerae non-O1 isolated was non-toxigenic but hemolytic with hyper-producing of metalloprotease.