HighlightsGastro-splenic fistula is rare condition that develops as complication of gastric or splenic pathologies.Delayed diagnosis of splenic abscess predisposes to the formation of gastro-splenic fistula.Gastro-splenic fistula could develop in patients with sickle cell disease.CT scan is the diagnostic modality of choice and upper GI endoscopy findings are often misinterpreted.Splenectomy and proximal gastrectomy is the treatment of choice for the gastro-splenic fistula.