Groove pancreatitis (GP) is a rare form of chronic pancreatitis that has been described by several names including para-duodenal wall cyst, pancreatic hamartoma of the duodenum, cystic dystrophy of heterotopic pancreas, and myoadenomatosis. GP is most common in males aged 40-50-years old with a history of alcoholism and/or smoking that present with abdominal pain, vomiting, and weight loss. Imaging typically reveals duodenal stenosis and cystic lesion(s) near the head of the pancreas. This form of focal, chronic pancreatitis affects the â€œgrooveâ€ between the duodenum, common bile duct, and pancreatic head. It is thought to be caused by functional and/or anatomical minor papilla obstruction from viscous pancreatic secretions. Most commonly, this occurs due to alcohol or smoking. In turn, there is impaired pancreatic enzyme outflow, Brunnerâ€™s gland proliferation, and resultant pancreatitis. Heterotopic pancreas in the duodenum and peptic ulcer disease are also possible contributing factors. Unlike chronic pancreatitis, there is no known association between groove pancreatitis, autoimmune disease or gallstones.