INTRODUCTION: Celiac disease is an autoimmune disorder that is triggered by gluten causing villous atrophy in the small intestine. Patients with celiac disease can present with a wide range of symptoms. We present a unique case of celiac disease presenting with duodenal ulcerations and small bowel intussusceptions. CASE DESCRIPTION/METHODS: A 60-year-old male with past history of stage I colon cancer status post partial colectomy 8 years ago presented with diarrhea and weight loss. The patient reported profuse diarrhea accompanied by a 20 lbs. weight loss that started six months ago. He denied other symptoms. His prior colonoscopies 1 year and 4 years after the partial colectomy were unremarkable. Physical examination was unremarkable. Laboratory data including hemoglobin was normal. Stool studies including infectious work up (clostridium difficile, stool cultures, ova and parasites) and fecal calprotectin were normal. A computed tomography (CT) scan of the abdomen and pelvis showed small bowel intussusception, mesenteric lymphadenopathy, and absence of any metastatic disease in the abdomen or pelvis (Figures a and b). A push enteroscopy was performed and revealed multiple scattered superficial ulcerations throughout the duodenum from the bulb to the third portion (Figures c and d). Repeat colonoscopy was unremarkable. Duodenal biopsies showed marked villous blunting, crypt hyperplasia and increased intraepithelial lymphocytes (Figures e and f) consistent with Celiac disease (Marsh 3b criteria). Blood was checked for celiac disease serologies and showed an elevated Anti-Tissue Transglutaminase IgA Antibody and a Deaminated Gliadin Peptide IgA Antibody. The patient was advised to start a gluten free diet. Four months after diagnosis, and being on a gluten-free diet, the patient had complete resolution of diarrhea and regained 20 lbs. of weight. DISCUSSION: Celiac disease can present with a variety of symptoms including diarrhea, nutritional deficiencies, weight loss, and gastric distension. Duodenal ulcerations and small bowel intussusception are exceedingly rare presentations of celiac disease. Even though these presentations have been previously been described separately, but they have not been reported together in an adult patient. Our case highlights that gastroenterologists should bear in mind the differential diagnosis of celiac disease in patients with small bowel intussusception, even in adults.