Objective: To present and analyze the diagnosis and treatment of the delayed massive gastrointestinal hemorrhage caused by fistula formation between pseudoaneurysm of the celiac trunk branches and digestive tract following abdominal surgery. Methods: The clinical data of 5 patients from January 2013 to September 2014 who developed massive gastrointestinal hemorrhage after abdominal tumor surgery and were identified as fistula formation between pseudoaneurysm of the branches and digestive tract by angiography were analyzed. Results: Of the 5 patients, the average time to postoperative gastrointeatinal hemorrhage was 53.6 d; the pseudoaneurysm was located in the splenic artery in 2 cases, in the common hepatic artery in 2 cases and in the left hepatic artery in one case; 4 cases underwent embolization therapy after angiography, and one case underwent covered stent implantation. No severe postoperative complications or perioperative death occurred. Postoperative follow-up was conducted for 6 to 16 months, during which time, no rupture and hemorrhage of the pseudoaneurysm occurred, but there was sudden death of unknown cause in one case who had undergone common hepatic artery covered stent implantation. Conclusion: The fistula between pseudoaneurysm of celiac axis branches and digestive tract is a rare but fatal complication after abdominal surgery and its awareness should be enhanced. Angiography and endovascular repair are preferred for its diagnosis and treatment, and avoidance of iatrogenic injury may be critical for reducing the incidence of this condition.