Segmental dilatation of the bowel and Dieulafoy's lesions are uncommon but important causes of gastrointestinal bleeding. These conditions are well described in adults but can occur in children as well. Here, the authors present a case of a boy with gastrointestinal bleeding from an ulcerated Dieulafoy's lesion found concomitantly within a segment of idiopathically dilated ileum. The simultaneous occurrence of both of these lesions in a symptomatic child has not been reported previously.