Aortoesophageal fistula is an extremely rare cause of upper gastrointestinal bleeding associated with high morbidity and mortality. Early clinical suspicion, as well as correct management since diagnosis, can increase the probability of survival of this gastrointestinal emergency. We present the first case reported of an aortoesophageal fistula successfully treated with the OTSC system, representing another therapeutic option for this high-risk entity.