Abstract: We present the case of a 38-year-old man from Africa who presented to our hospital with melena. After workup, he was found to have noncirrhotic portal hypertension from schistosomiasis. He required multiple banding procedures to control variceal bleeding. Worldwide, this disease is epidemic in Africa, Asia, and South America; but in the United States, only a few cases are seen in tertiary centers, mainly in immigrants from these nations. This case illustrates that complications of chronic hepatic schistosomiasis are treatable, and clinicians should have a broad differential when providing care to patients from outside the United States.