Benralizumab is a monoclonal antibody against IL-5 receptor alpha. It’s approved for severe eosinophilic asthma but not yet to other eosinophilic conditions. The authors describe a case of an off-label use in treating gastrointestinal (GI) eosinophilic syndromes. A 73 years-old male, with diagnose of asthma, polyposis and sinusitis was referred to our facility in 2018 due to suspicion of NSAIDs allergy and difficult to control asthma. He also had a past medical history of eosinophilic gastroenteritis and colitis confirmed by biopsy in 2016. Asthma symptoms started in 2006 with exercise dyspnea and later confirmed in a pulmonary lung test. He started budenoside/formoterol 160/4,5 ug daily and before exercise. Between 2015 and 2018 there was a worsening of the complaints. The patient was then prescribed with fluticasone/vilanterol 92/22 ug and montelukast 10 mg daily with no clinical improvement. Simultaneously, he had worsening GI symptoms with the need of systemic steroids (prednisolone 20 to 40 mg daily). Due to this fact it was not possible to do NSAIDs provocation test but the clinical history was very consistent and the diagnose was assumed. At the time of the appointment, blood eosinophil count was 210 cells/mcL(610 in april 2017), ACT (asthma control test) score 19 and mAQLQ(mini asthma quality of life test) 3,0. Inhaler technique and adhesion were reviewed. In october 2019 he started therapy with benralizumab. 16 weeks after the first injection he showed clinical improvement without asthma exacerbations and better GI condition. Systemic corticoids were reduced and stopped after week 24. There was no report of adverse reactions. Improvement on asthma scores(ACT 23; mAQLQ 4,7) and a reduction in blood eosinophil count(to 0 cells/mcL) was seen. 52 weeks after starting benralizumab, the colonoscopy showed healing of the colonic mucosa and no eosinophilic inflammation was found on biopsy. In november 2021, he doesn’t report asthma or GI symptoms. He is medicated with fluticasone/vilanterol 184/22 ug, montelukast 10 mg and topical nasal budesonide 100 ug daily and without systemic steroids since June 2020. Our findings suggest that benralizumab has a potential role in treating other eosinophilic conditions. More studies with a larger number of patients with past clinical history of GI syndromes on benralizumab therapy should be carried out to better understand benralizumab’s action mechanism in intestinal mucosa and to understand its potential benefits.