Purpose <p>To present a unique case of vascular supply to the gastrointestinal organs as anatomical variants have variable clinical implications and must be recognized to avoid adverse outcomes.</p> Methods <p>Describe the embryological origin of vascular supply of gastrointestinal organs and present a few variants described in the literature.</p> Results <p>On angiogram, patient was found to have total colonic supply via the inferior mesenteric artery. This is a rare anatomical variant which altered management in this child with massive lower gastrointestinal bleed due to sacral neuroblastoma metastasis and mucormycosis colitis.</p> Conclusion <p>Vascular anatomic variants have clinical implications that can alter management.</p>