Paraduodenal hernia accounts for 30-50% of all internal hernias but is responsible for only 1% of all cases of small bowel obstruction. 50% of patients present with obstructive symptoms, whereas the remainder often describe vague abdominal pain. This video describes the embryology, presentation, work-up, and management through 2 cases. The first involves a 41 year-old male with chronic abdominal pain. Radiologic workup included upper gastrointestinal series and abdominal CT scan. He was diagnosed with a right paraduodenal hernia and treated with exploratory laparotomy, division of the lateral attachments of the ascending colon, and appendectomy. The second case involves a 24 year-old male with a 3 year history of intermittent abdominal pain. Work-up included an abdominal CT scan which revealed a left paraduodenal hernia.This condition was treated through laparoscopic exploration with reduction of incarcerated bowel and repair of the defect. Although an uncommon clinical entity, surgeons should be familiar with this condition, and knowledge of the anatomy is crucial in avoiding injury to the mesenteric vessels. Additionally, paraduodenal hernia is amenable to laparoscopic treatment in select cases.