Gastric antral vascular ectasia (GAVE) is a rare but severe cause of gastrointestinal (GI) bleeding in the elderly, mean- while, it is commonly associated with connective tissue diseases. The GAVE diagnosis is clinically challenging due to its little-known characteristic symptoms and limited case studies. A 43-years-old male patient with pulmonary tuberculosis complained of chronic dyspepsia and GI bleeding. Hence, gastric tuberculosis was suspected. Initial- ly, this diagnosis was not suitable as GAVE considering that the patient had chronic GI symptoms with underlying tuberculosis, middle-age, and no other organs issue was affected except the lung, however, upper GI endoscopy discovered watermelon stripes pattern. Therefore, GAVE diagnosis was established with differential diagnosis gastric tuberculosis while histopathology results further confirmed GAVE diagnosis. Appropriate treatment was given until there was no further dyspepsia and GI bleeding. GAVE diagnosis needs to be considered in middle-aged patients with pulmonary tuberculosis as an unusual comorbid, specifically, in gastric tuberculosis-suspected patient before endoscopy due to chronic dyspepsia and GI bleeding.