Gastrocolocutaneous fistula is a rare potential complication of percutaneous endoscopic gastrostomy (PEG). This case report is a description of the approach used to manage a gastrocolocutaneous fistula that developed after a PEG procedure. A 35-year-old male with amyotrophic lateral sclerosis had a PEG tube inserted in the endoscopy unit due to recurrent episodes of aspiration pneumonia. During the postoperative period, the PEG tube was withdrawn as a result of bilious discharge from the rim of the tube and maceration of the skin around the tube The patient was referred to us due to the leakage of feces from the PEG site. Given the high rate of flow observed during follow-up and the unlikelihood of spontaneous closure, surgical repair was planned. The operation included repair of a fistula between the stomach and the colon, partial gastric resection, and primary sutures to effect a repair of the colon. Proper management of complications of a PEG procedure can lead to a quick and effective recovery.Keywords: Complication, gastrocolocutaneous fistula; percutaneous endoscopic gastrostomy.