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Gastroduodenal fistula (GDF) or double pylorus (DP), also called double-channel pylorus, is a rare condition seen in 0.001%–0.4% of upper gastrointestinal endoscopies. The condition is characterized by the presence of two openings from the gastric antrum to the duodenum, which may be congenital or acquired. Acquired DP is usually an uncommon complication of peptic ulcer that erodes and creates a fistula between the duodenal bulb and the prepyloric antrum. We report a case of elderly male patient who was evaluated for the complaints of upper gastrointestinal bleed and was found to have peptic ulcer disease with GDF.