Although uncommon, most common site for adenocarcinoma of small bowel is duodenum. In duodenum, it is found most commonly in second part secondary to a villous adenoma in periampullary region. Carcinoma of third and fourth part is extremely rare. We had 60 year old lady presented with history of vomiting following food intake for 15 days and generalised weakness and loss of weight since 6 months. Patient was diagnosed adenocarcinoma duodenum in third and fourth part with regional lymph node metastasis via CT scan, OGD scopy and biopsy. Patient underwent a curative resection by Whipple’s procedure with lymph node excision.