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Papillary adenomas of the common bile duct are a rare entity with few published case reports and limited knowledge on its natural progression. We report here a case of common bile duct papillary adenoma in a 69-year-old female who presented with symptoms of common bile duct obstruction. She was treated with local endoscopic excision of the mass that has benign features. A brief review of literature is discussed with a proposed treatment plan for follow-up with surveillance endoscopy and ultrasonography as opposed to the radical resection for benign findings on pathology.