59-year-old female presented with a two-year history of a 12mm gastric ulcer. Biopsies obtained demonstrated reactive hyperplasia with no active or chronic gastritis. Stains for H. Pylori were negative, and no evidence of dysplasia or carcinoma was seen. Despite aggressive medical therapy, repeat endoscopy revealed a non-healing 12mm ulcer in the antrum. Subsequently, she had a laparoscopic antrectomy, truncal vagotomy, with a Billroth I reconstruction. The gastroduodenal anastomosis was created with a linear stapler, and the gastrotomy and duodenotomy were sutured intracorporeally. At six month endoscopic follow-up, the patient did not have any evidence of residual gastric ulcer disease.