Purpose Malignancies involving the oesophagus can present with emergent upper gastrointestinal bleeding as well as dysphagia, which can have significant and debilitating effects on a patient’s nutritional adequacy and quality of life. Endoscopic oesophageal stenting can provide significant symptomatic relief in the setting of both acute haematemesis and malignant dysphagia by limiting further trauma to areas of direct malignant invasion, as well as providing persistent luminal patency. Methodology and results A 61-year-old gentleman presented to a rural emergency department with acute haematemesis and melaena with associated haemorrhagic shock. This was in the context of a subacute history of dysphagia to solids and liquids and a background of a heavy smoking history and untreated hepatitis C. After appropriate resuscitation, the patient proceeded to gastroscopy which demonstrated a mass with suspected distal oesophageal sidewall perforation/erosion and associated old clot and food residue. The mass was biopsied and a partially covered metal oesophageal stent was inserted endoscopically with resolution of the associated haemorrhage. Subsequent histopathology demonstrated primary lung adenocarcinoma with direct oesophageal invasion. The patient required revision of their stent, was subsequently able to achieve nutritional adequacy and was discharged with ongoing dietetics support and medical oncology followup. Conclusion Partially covered metal stents are effective in the emergent setting for management of oesophageal bleeding and malignant dysphagia in the rare clinical setting of lung adenocarcinoma with direct invasion of the oesophageal sidewall. They also provide a means to subsequent nutritional adequacy.