Gallstone ileus is a rare cause of small bowel obstruction (SBO), representing 1–4% of all SBO. Bouveret’s syndrome is a raresubcategory of gallstone ileus where a gallstone lodges itself intothe duodenum and causes gastric outlet obstruction. It constitutes 2–3% of all gallstone related obstructions in the alimentary tract. Here we present a case of 68 year old female, known case ofbipolar disorder and diabetes, presented to ED with complaints of  abdominal discomfort and decreased appetite. On investigation, patient was diagnosed with cholecystoduodenal fistula and gall stone ileus, later on operated and discharged in stable condition.