A 43-year-old male patient presented to us with peri-anal pain, he was a chronic alcoholic with a recent history of change in drinking pattern in the last 3 months with heavy drinking daily. On examination, he was having redness and induration in the left perianal region suggestive of perianal abscess. His bilirubin level was 10.2 mg/dl, sgot was 172, sgpt 74, INR was 2.07, White blood cells count was 17000, procalcitonin 2.1, and creatinine 1.5. His ultrasonography showed fatty liver with mild free fluid in the abdomen. His vitals were normal. Based on history, physical examination, and investigations he was provisionally diagnosed as a perianal abscess superimposed on alcoholic hepatitis. The patient’s Maddrey’s Discriminant function score was 79.2 suggestive of a poor prognosis. However, steroids were not started as the patient was having an active infection on examination. Patient’s He underwent left perianal abscess drainage, intra-operative he was found to have a large ischiorectal abscess with approximately 100 cc pus drained out. He was discharged the next day, however after 3 days he came to the emergency with severe perianal pain, and perianal bleeding. On examination it was bleeding from the granulation tissue without any sign of infection., his vitals were normal. His fresh bilirubin was still 10.4, with sgot of 200 and sgpt of 88 and INR was 2.4. White blood cell counts were 14000 and procalcitonin level of 1.2. Confirming altered liver functions were due to alcoholic hepatitis rather than sepsis. His hemoglobin was 6.9 and he was transfused one packed cell volume and fresh frozen plasma. Subsequently, the bleeding subsided and the patient was discharged again. After four days patient again presented with granulation tissue bleed, with normal vitals with a good healing wound. But, again bilirubin was 7.2, Inr was 1.8, hemoglobin 6.4, WBC count normalized to 8000, and procalcitonin level 0.45. This time colonoscopy was performed which failed to show any internal source of bleeding. As, this time infective markers stabilized we started prednisolone 40mg/day to treat alcoholic hepatitis, following this after 1-week patient came for follow up with no complaints of fresh bleeding, the patient had slight perianal pain but otherwise, bilirubin decreased to 2.1, Inr 1.31, white blood count decreased to 7000. The patient was continued on prednisolone for 28 days and after that it was. Stopped. At the time of stopping prednisolone, his liver function tests were normalized with no fresh complaints. The patient was advised to complete abstinence from alcohol.