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Dr. Abdurrahman Yurtarslan Onkoloji Eğitim ve Araştırma Hastanesi, Tıbbi Onkoloji Kliniği, Ankara Bevacizumab is a monoclonal antibody which targets the vascular endothelial growth factor molecule. It is indicated for the treatment of recurrent and metastatic colorectal cancer. A 66-year-old woman was operated with left hemicolectomy who had a tumor in the left colon causing a total obstruction. Her tumor stage was IV (T3N1M1). 5-Fluorouracil, folinic acid,irinotecan and bevacizumab chemotherapy was started to the patient at the forty day of the colon operation. The patient was hospitalized after first administration of the 5th chemotherapy cycle because of febrile neutropenia. Abdominal pain began although the neutrophil count was within the normal ranges. The patient was operated with the diagnosis of acute abdomen. A one centimeter sized perforation was seen at the ilial loop which was 80 cm proximal to the ileocaecal valve. The patient died 8 days after the operation. Although bevacizumab is generally a well-tolerated agent, one must pay attention. Keywords : Bevacizumab; small intestine perforation; metastatic colon carcinoma