Gastrointestinal complications following cardiac surgery occur in 0.3% to 2% of cases, ranging from relatively simple issues like paralytic ileus or constipation to life-threatening conditions such as gastrointestinal hemorrhage, with mortality rates ranging from 10% to 60%. Effective preoperative risk assessment, along with careful intraoperative and postoperative management, is crucial in minimizing the risk of these complications in cardiac surgery patients. Several risk factors contribute to GI tract complications, including hypoperfusion of the splanchnic bed, sympathetic neuronal derangement, inflammatory mediators, opioid use, electrolyte imbalances before and after surgery, and the use of anticoagulation and antiplatelet therapies. Treatment options vary, ranging from medical management and modification of modifiable risk factors to active interventions such as endoscopic bleeding control and surgical abdominal exploration.