A case of 39 year-old man with acute duodenal lesions was reported. On admission, he had severe abdominal pain hematemesis. On the day of onset, endoscopic finding showed many erosions from the anterior and posterior walls of the duodenal bulb, to the pars descendens. He had no optical inducing factors of the acute duodenal lesions. Two weeks later, the acute duodenal lesions were healed completely.