Enteropathy-Associated T Cell Lymphoma (EATL) is a rare malignancy with annual incidence of 0.5–1 per million people and typically manifests with symptoms like chronic diarrhea, weight loss, and malabsorption (1). In this case report, we describe an unusual presentation of EATL in a 49-year-old otherwise healthy gentleman who presented with sudden-onset severe abdominal pain and vomiting. Despite the absence of classical symptoms, clinical examination revealed signs of peritonitis, prompting further investigations. Chest X-ray confirmed the presence of free gas under the diaphragm, leading to the necessity of an emergency laparotomy. Intraoperatively, a mobile mass was discovered, and surgical intervention was performed. Histopathological examination confirmed T cell lymphoma, emphasizing the importance of considering rare malignancies in the differential diagnosis of acute abdominal pain.