Introduction:About 0.3% to 0.5% of gastrointestinal malignancies are duodenal adenocarcinomas, an uncommon gastrointestinal malignancy that was first described by Hamburger in 1746. Due to the vague nature of duodenal adenocarcinoma symptoms, most patients arrive with advanced disease and a poor prognosis with high morbidity and death rates. Although it can originate anywhere in the duodenum, including the duodenal bulb, duodenal adenocarcinoma most frequently affects the descending duodenum (D2) [1, 2]. Here, we present a case report of an extremely rare location of duodenal adenocarcinoma in a patient with complex medical comorbidities. We also provide a comprehensive literature review on duodenal adenocarcinoma, focusing on their occurrence in the duodenal bulb.