Sepsis and mechanical ventilation can cause significant physiological stress leading to gastric mucosal damage and gastrointestinal bleeding. This study aims to assess the prevalence and risk factors for occult blood in stool among mechanically ventilated sepsis patients. Aim &Objectives: 1. Assess the prevalence of occult blood in stool in sepsis patients receiving mechanical ventilation. 2. Determine the associated risk factors. Methodology: A pilot observational study was conducted from June 1, 2019, to October 31, 2019, in the ICU of Chirayu Medical College. Included were sepsis patients aged 18-70 years on mechanical ventilation for more than 48 hours. Exclusions were patients with a history of gastrointestinal bleeding, ulceration, recent gastrointestinal surgery, or active bleeding. Demographic, clinical, and laboratory data were collected, and stool samples were tested for occult blood. Data analysis was performed using SPSS version 23. Results: Among 129 patients, 76 (58%) tested positive for occult blood. Significant risk factors included hypertension (P = 0.00001), absence of sedation and analgesia (P = 0.00001), platelet count <50,000 (P = 0.0007), high mechanical ventilation settings (P = 0.0004), and raised PT/APTT (P = 0.003). Diabetes and chronic kidney disease were not significant. Conclusion: There is a high prevalence of occult blood in stool among mechanically ventilated sepsis patients, with significant risk factors identified. Routine screening and proactive management are recommended to prevent gastrointestinal bleeding in this population. Further research is needed to confirm these findings and explore additional preventive strategies.