Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disorder of hematopoietic stem cells characterized by chronic intravascular hemolysis, nocturnal hemoglobinuria, thromboembolic events and secondary bone marrow failure caused by uncontrolled complement activation. Generally, chronic abdominal pain and iron deficiency anemia are considered typical symptoms of gastrointestinal diseases, but are also common in PNH. We report a case of PNH presenting with chronic abdominal pain and iron deficiency anemia, along with a relevant literature review.