The hemorrhagic syndrome in its clinical, cutaneous and ocular diversity most often constitutes the circumstances in which acute leukemia is discovered. Digestive mucosal involvement is rarely indicative of serious bone marrow failure, thus posing a problem of etiological diagnosis in a gastroenterological medical setting [1]. In the literature, it varies from 2 to 10-15% depending on the study and is considered a sign of poor prognosis requiring early diagnosis for better management [2]. We report a case of a 59-year-old woman admitted for rectal bleeding associated with an anemic syndrome. The initial clinical examination showed a finger cot stained with bright red blood. The blood count had shown anemia at 6.4g/dl microcytic, normochromic, neutropenia at 1.8x103, thrombocytopenia at 36.103. Colonoscopy and esogastroduodenoscopy were normal. Blood smear and myelogram were in favor of Acute Myeloid Leukemia. Karyotype and immunophenotyping were not performed. Symptomatic treatment was offered. The evolution is marked by the improvement of the clinical signs. This association, acute myeloid leukemia and rectal bleeding is rarely described in the literature.