Most patients with gastric cancer are symptomatic. Weight loss and persistent abdominal pain are the most common symptoms at initial diagnosis. Approximately 25 percent of patients with gastric cancer have a history of gastric ulcer. Iron deficiency anemia (IDA) is a common, often early, sign of gastric cancer, affecting roughly 40%–58.7% of patients at diagnosis, frequently caused by chronic occult gastrointestinal bleeding or tumor-related nutrient malabsorption. It is highly associated with stomach cancer, especially in men and individuals over 80. Grossly thickened stomach has many differential diagnoses, including both benign and malignant and in latter adenocarcinomas are most common. Case report: We present a sixty- two -year- old female, not a known case of any chronic illness, presented with generalized fatigue four years back and on evaluation was found to be having iron deficiency anemia, for which she was transfused parenteral iron. It led to symptomatic improvement but it remained for few months only. After a gap of six months, she again developed same symptoms and iron deficiency anemia which was again treated with parenteral iron therapy. In last four years, six episodes occurred of recurrent iron deficiency anemia which were treated in same manner. At this point of time, she reported in our department and on work up again iron deficiency anemia was detected. On probing in detail, she admitted that she intermittently was passing blackish-brownish stools, which persisted even after stopping oral iron therapy. She told that all his past private practitioners attributed this to oral iron therapy. The rest of biochemical investigations including liver & renal function test, celiac profile, thyroid profile, blood sugar, viral screen and ultrasonogram abdomen was essentially normal. The upper gastro-intestinal endoscopy showed two lesions. First one was ulcer-polypoidal, just after crossing GE junction and second one was polypoidal lesion in body. The biopsy on histopathological examination confirmed it to be adenocarcinoma. The Computed tomography scan showed thickened stomach walls with polypoidal lesion in body. The PET-CT scan showed FDG avid intraluminal lobulated lesions arising from body of stomach which were suggestive of neoplastic etiology. The patient was referred to oncosurgeon and is being worked up for surgery. Our case report case has two distinct points, first is recurrent iron deficiency anemia should not be taken lightly that too in old age when other causes are not pin-pointed. The other uncommon thing was two lesions at two different sites of stomach which is very important in deciding the type of surgery and extent of resection in the patient.Conclusion: Iron deficiency anemia, that too recurrent in old age should be evaluated in detail and gastro-intestinal malignancies should be ruled out. For the same, upper gastro-intestinal endoscopy and colonoscopy should mandatory be included in the work-up.