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Superior mesenteric artery syndrome is an unusual cause of small bowel obstruction. This is the case of an 18-year-old woman with no prior surgical history who presented to the emergency department with intractable vomiting and midepigastric abdominal pain for 3 days and who was ultimately diagnosed with superior mesenteric artery syndrome. Conservative management resulted in the resolution of her symptoms. Superior mesenteric artery syndrome should be considered as a possible etiology of small bowel obstruction in specific patient populations.