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The advent of PPI’s and the improved treatment of H. Pylori has greatly reduced the frequency that peptic ulcer surgery is performed. PPI’s have helped to sub-select the most severe cases of ulcer disease presenting for surgical evaluation. Chronic peptic ulcer disease refractory to medical treatment necessitates surgical intervention. The primary indication for gastric resection in the setting of PUD is chronic obstruction caused by scarring. Surgical intervention must achieve acid suppression, resection of concerning gastric pathology and reconstruction. We present laparoscopic truncal vagotomy with antrectomy as a safe, effective option that leads to excellent functional results.