A young female with two episodes of obstructive jaundice and frequent postprandial vomiting over a 2-month period was found to have marked narrowing with irregularity of the mucosa of the descending duodenum and dense eosinophilic infiltration of the muscular and serosal layers. This unusual presentation illustrates the wide variety of gastrointestinal manifestations of eosinophilic gastroenteritis.