A case of gastrointestinal phycomycosis, a highly lethal fungal infection, is presented. Radiographic, operative and histopathologic features are discussed. Pathogenesis of the disease and the importance of underlying illness, malnutrition, immunosuppression and antibiotic therapy are considered. The literature is reviewed and current approaches to diagnosis and management are summarized. Greater awareness of the clinical setting in which gastrointestinal phycomycosis may develop and earlier consideration of the diagnosis are prerequisite to improved survival.