Traumatic pelvic arteriovenous fistulas (AVFs) are exceedingly rare and can lead to significant morbidity. Herein, we describe the case of a 31 year-old male who presented with two months of recurrent gross hematuria following a gluteal gun-shot wound and was found to have a right internal iliac AVF. To our knowledge, this is the first reported case of a post traumatic pelvic AVF presenting with gross hematuria.