Gastrocolic fistula is a rare complication of benign gastric ulcer disease. It has been associated more commonly, in the past, with marginal ulceration following gastrojejunostomy for peptic ulcer disease. We will describe a classic case of gastrocolic fistula as a complication of acetylsalicylic acid abuse in a middle aged female with a remote history of aspirin induced ulcer. Her presentation was classic and required a surgical approach with excellent recovery. We will describe the clinical, radiographic, endoscopic and surgical aspects of this interesting and unusual disorder.