The rectum is spared in most patients with spontaneous ischemic colitis because of its abundant collateral blood supply, and thus ischemic proctitis is a rare clinical entity. In most reported cases, it has been of acute onset after aortoiliac surgery, radiotherapy, or other vascular intervention. This report describes the endoscopic diagnosis and the treatment of recurrent rectal hemorrhage in apatient withspontaneous chronic ischemic proctitis. Chronic ischemic proctitis should be included in the differential diagnosis of lower-GI bleeding, especially for elderly, bed-ridden patients with atherosclerotic disease.