Presentation: 44-year-old male presented with intermittent abdominal pain with nausea and vomiting for 9 years. The pain was associated with weight loss and loss of appetite. CT scan for the patient showed dilated stomach with compression of the third part of the duodenum by the superior mesenteric artery and 3D reconstruction of the CT and the MRI showed a narrowed angle (11) of the aortomesenteric angle confirming the diagnosis of superior mesenteric artery syndrome. The patient underwent laparoscopic duodenojejunostomy. Intra-operatively the ligament of treitz was identified and the SMA was seen. Dissection started to the right of the SMA and the third part of the duodenum was seen and periotnium was dissected from it. Measurement of the jejunum (20 cm from ligament of treitz) and side-to-side anastomosis was done using laparoscopic GIA stapler with white cartridge. Closure of the common eneterotomy with PDS suture in continuous fashion and methylene blue leak test was done. A drain was placed near the anastomosis. The patient recovered well and gained weight after the surgery.