Mechanical obstruction is a serious and potentially fatal complication of gallstones. We report a case of Bouveret's syndrome where gastric outlet obstruction was caused by a giant gallstone being impacted in the duodenum. An 80-year-old man presented with a 7-day history of obstructive symptoms and hiccups. Clinical and biochemical assessment showed dehydration with mild epigastric tenderness. Abdominal X-ray showed an opacity in the right hypochondrium (figure 1). CT scan showed a large gallstone impacted in the …