Adenoid hypertrophy, a common disorder in pediatric population can present as a variety of symptoms including snoring, nasal obstruction and hyponasal speech to obstructive sleep apnea (OSA), chronic rhinosinusitis and recurrent otitis media. Here we present a four years old boy presenting with periodic hematemesis for several months and the complaint of persistent presence of blood in saliva for whom complete GI evaluation revealed no obvious source. After otolaryngology consultation, detailed history and nasopharyngoscopy revealed hypertrophied adenoids as the source of bleeding. Surgical adenoidectomy was curative after 9 months follow up. This paper presented our experience in the management of an adenoid hypertrophy case presenting with oropharyngeal bleeding due to a mass-like lesion that is, to our knowledge, the first case of this issue.