Hypertrophic pyloric stenosis presenting beyond infancy is an uncommon occurrence. The etiology of adult onset pyloric stenosis is unknown. In this case report, we describe a 14-year-old boy who presented with nausea, intermittent vomiting, and abdominal pain. He underwent upper gastrointestinal series, which demonstrated persistent narrowing of the pylorus. He was referred to Pediatric Surgery for evaluation and subsequently underwent laparoscopic pyloroplasty. Postoperatively, the patient did well, and at 20 months, he continues to be asymptomatic.