Truncal vagotomy with drainage procedure with either pyloroplasty or gastroenterostomy used to be the standard of care for peptic ulcer disease until the advent of medical therapies and discovery of H. pylori as the cause of a majority of peptic ulcer disease. Since then, the incidence of vagotomy procedures has declined and is reserved for patients refractory to medical management and endoscopic dilations. We present a patient with recurrent peptic stricture due to long term NSAID use for chronic back pain. Even after alleviation of the patient's back pain after spinal surgery and discontinuation of NSAIDs, the patient continued to have gastric outlet obstruction from duodenal stricture that failed medical therapy and eight endoscopic dilations. She underwent laparoscopic truncal vagotomy with gastrojejunostomy. We present this video to demonstrate an effective laparoscopic approach and review the technical aspects of this procedure which is no longer in common practice.