Accidental injuries in children are a common presentation in the primary care clinic. This includes blunt abdominal trauma, which could go unrecognised and cause severe sequelae. A good focused history taking, especially on the mechanism and force of injury coupled with careful physical examination, is crucial to excluding the possibility of internal viscus injuries. We present a case of an isolated gastric perforation, a rare injury secondary to blunt trauma, in a boy who presented with subtle signs and symptoms.