This is a case report of a neonate with impending gastric rupture due to malrotation with gastric outlet obstruction. A preoperative plain abdominal X-ray showed expansion of the gastric bubble. A barium meal demonstrated an unusual bulging of the gastric wall extending from the fundus to the body of the stomach on the greater curvature side and malrotation of the duodenal loop. At operation a malrotation with volvulus and a rupture of the seromuscular layer with bulging of the mucosa in the stomach was found. We think that this unusual bulging of the gastric wall in the barium meal is an important radiological sign of impending gastric rupture.