BACKGROUND Gastric lipomas, though rare, are noteworthy for their potential to cause upper gastrointestinal bleeding. This case report highlights the diagnostic and management challenges associated with this uncommon entity. METHODS We present a case of a 39-year-old male with epigastric pain and hematemesis, ultimately diagnosed with a gastric lipoma in the antrum. Endoscopy revealed a submucosal lesion with mucosal ulceration, confirmed by imaging studies. Surgical resection was performed, leading to a favorable outcome. Gastric lipomas are benign tumors that can present with gastrointestinal bleeding, abdominal pain, or obstruction. Diagnosis relies on imaging and endoscopic findings, with biopsy often inconclusive due to the submucosal location. Surgical resection is the preferred treatment for symptomatic or large lipomas, while observation may suffice for asymptomatic lesions. CONCLUSIONS Gastric lipomas, although infrequent, pose a challenge for diagnosis, especially when associated with bleeding. Surgical resection remains the cornerstone of management for symptomatic or large lipomas, with observation being an option for asymptomatic lesions.