Bevacizumab is a monoclonal antibody which has shown promising results in the treatment of varied malignant pathology, including metastasized colorectal cancer. It acts by inhibiting VEGF (vascular endothelial growth factor), and one of its most cited complications is intestinal perforation, by mechanisms which are not yet fully understood. We present the case of a 68 year old patient, operated for metastasized colorectal cancer, which underwent chemotherapy with Bevacizumab, and shortly after initiating therapy developed fistula of low colorectal anastomosis, followed by ischemic perforation of the small intestine.