A 40 year old patient presents with acute pain abdomen with abdominal distension. History of unusual heavy meal one day before and following which symptoms appear. Few episodes of vomiting were associated. Resuscitation done. Straight x ray shows dilated gastric shadow. Patient posted for laparotomy after failing of conservative measures. On opening abdomen, hugely distended stomach seen with thinned out gastric wall and patchy areas of discolouration. A side to side gastrojejunostomy done after decompression on the dependent stomach. Post-operative recovery was uneventful. Psychological evaluation did not reveal any abnormality. Acute gastric dilatation can cause mucosal necrosis and gastric perforation therefore early diagnosis and gastric decompression is the key. Though most patients respond to conservative measures, failing which surgical decompression is needed.