An ethnically Chinese patient with newly diagnosed metastatic gastro-intestinal stromal tumour initially treated with imatinib mesylate developed severe interstitial lung disease. As his condition improved after cessation of imatinib mesylate and treatment with corticosteroids, he was started on sunitinib malate. His clinical course was then unfortunately complicated with intra-tumour bleeding. This case report illustrates the dilemmas and complexities associated with treating patients with gastro-intestinal stromal tumours with the new tyrosine kinase inhibitors.