57-year-old female patient presented with intermittent, progressive upper abdominal pain of 6-month duration. The physical examination was unremarkable. A duodenal polypoid lesion with a long stalk was seen at esophagogastroduodenoscopy (Fig. 1A). Routine laboratory tests were normal. We performed endoscopic ultrasound (EUS) to characterize the lesion, which appeared as a heterogeneously hyperechoic lesion originating from the third layers (Fig. 1B). Using EUS, the patient was diagnosed as having a duodenal lipoma. Using an electrocautery snare, we transected the upper third of the polypoid lesion to unroof it. This showed fat, consistent with the EUS finding (Fig. 1C). The histopathology of the excised specimen confirmed the diagnosis of lipoma. Her abdominal pain eventually subsided after endoscopic treatment.