BACKGROUND: Nonfearful panic disorder (NFPD) is a panic condition masked under the appearance of somatic symptoms only, without the component of fear, and it represents a challenging diagnostic task. METHOD: This is the first case report of NFPD in a male patient with acute gastric pain and gastrointestinal disease (atrophic gastritis and H. pylori infection). RESULTS: The patient showed atypical panic symptoms and demoralization on the Diagnostic Criteria for Psychosomatic Research screening. He was successfully treated with anti-panic medication and cognitive-behavioral therapy. DISCUSSION: The case report shows that accurate psychosomatic assessment may help clinicians avoid diagnostic delay, prevent the administration of unnecessary medications, and give patients more appropriate treatment.