A 39-year-old woman with alcohol-related cirrhosis and autoimmune hepatitis developed disseminated intravascular coagulation (DIC), a serious condition that can lead to severe bleeding and organ failure. She arrived at the emergency department (ED) with a minor head injury and active bleeding from a groin ulcer. Her initial assessment was complicated by alcohol intoxication and concerns of domestic violence due to visible bruising. A delayed laboratory evaluation confirmed DIC, associated with her deteriorating liver condition and hepatic encephalopathy. Treatment included administering blood products, and she was later discharged to follow up with a hepatology department. This case highlights the difficulties in diagnosing DIC in patients with alcohol-related issues, where trauma-related bruising can mask underlying coagulopathy. It stresses the need for vigilance in identifying DIC in cirrhotic patients and the utility of the International Society on Thrombosis and Haemostasis DIC score. Early detection and a collaborative approach are critical for improving patient outcomes.