This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage rectal bleeding — a case which they are likely to encounter in the future in a general practice setting. It presents the case of a 46-year-old man who is unable to read or write and who has learning difficulties. The patient has not had any serious illnesses apart from minor arthritic pains for which he takes the occasional paracetamol. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.