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Gastric cancer is the fifth most common cancer and the third leading cause of cancer deaths globally. Its incidence is highest in Asia and lowest in Africa. In 1.1%–4.7% of all gastric cancer cases, at least one other primary tumor may be found. We present the case of a 55-year-old male from West Asia who underwent proximal gastrectomy for Stage IIB gastric adenocarcinoma. One year into postoperative surveillance, routine abdominal imaging revealed a liver tumor. A left hepatectomy was performed, histology of which revealed cholangiocarcinoma. Cholangiocarcinoma though rare may occur following a diagnosis of gastric cancer, thus the strong need for routine abdominal imaging during surveillance of these patients. Any suspicious lesions discovered during follow-up need to be vigilantly evaluated so that patients are offered appropriate and timely treatment.