The problem of treatment of acute bleeding ulcers remains a most serious challenge, in the first place because of the frequent occurrence of this condition and the invariably high lethality rate associated with it that amounts up to 10%. The combined application of endoscopic hemostasis and modern antiulcer therapy is considered to be the «golden standard» for the management of ulcer bleeding. The use of these methods allows either to avoid the urgent surgical interventions and carry them out on the pre-planned basis or even to prescribe the conservative treatment for certain patients. One of the rare complications of chronic duodenal ulcers (CDU) is the formation of a pathological fistula into some adjacent organs, such as gallbladder, the common bile duct, segmented intestine, right kidney, aorta, and inferior vena cava. The acquired duodenal fistulas are the extremely rare phenomena resulting from ulcer penetration. At the same time, the duodenal bulb ulcer may be a cause of gastrointestinal hemorrhage that should be treated by the traditional methods generally employed to arrest bleeding associated with any newly detected ulcer. This article describes the clinical case of the successful combined endoscopic hemostasis in the patients presenting with a chronic duodenal bulb ulcer and the newly diagnosed bulbo-duodenal fistula.