Reactivation of varicella zoster virus (VZV) is a common event after stem cell transplantation (SCT). When activated in the abdominal cavity, the infection may be life threatening. Visceral presentation with VZV infection is uncommon, although probably an under-diagnosed event in post-SCT patients. The interval from onset of abdominal pain to the development of skin eruptions may delay the initiation of specific antiviral therapy and symptoms may be incorrectly diagnosed as surgical disease or graft-versus-host disease. We describe the case of a 53-year-old man who had undergone stem cell autograft for multiple myeloma and developed visceral VZV infection with hepatitis, melaena and subileus 7 months later.