Background: Choriocarcinoma syndrome is rare and challenging in practice. The condition is fatal if it is associated with uncontrolled bleeding. Objectives: The current study aimed to present our experience managing a case of choriocarcinoma syndrome, which complicated a gestational trophoblastic disease. Patients and methods: A case of 35-year-old female with a history of molar pregnancy that was missed and diagnosed with choriocarcinoma stage 4. The patient suffered from a life-threatening gastrointestinal (GIT) bleeding. Results: The patient was managed by intensive transfusion protocol and chemotherapy [EMA-EP protocol (etoposide, methotrexate, actinomycin D, etoposide, cisplatin) and intercaecal methotrexate]. Severe life threating bleeding stopped after 72 hours of active management and blood transfusion. Following six cycles of this protocol, BHCG level returned to normal level with marked improvement of metastatic lesions. Conclusion: Choriocarcinoma syndrome is a life-threatening condition that requires intensive management. Cure-rate index is high if the condition is appropriately managed.