Even though teratomas are usually asymptomatic, they sometimes present with symptoms due to local compression as with this case where the child presented with chronic abdominal pain, occasional vomiting, constipation and refusal of feeds which led to anemia on two occasions. This prompted further investigations and the characteristic presence of tooth-like structures, bones and fat components are characteristic for teratomas. However, child was referred to a higher center for surgery and histopathology confirmation.