A 54-year-old male with decompensated cirrhosis (Child-Pugh B8, MELD-Na 23) and a prior ileostomy was admitted with hemorrhage from the stoma. Initial hemostasis was achieved with mechanical suturing, but recurrent bleeding led to worsening anemia and hepatorenal syndrome. Contrast-enhanced CT identified peristomal varices without thrombosis. Endovascular cyanoacrylate embolization was performed successfully, with no further bleeding. This case highlights peristomal varices as a rare but serious complication in cirrhosis, requiring multidisciplinary management.