A twenty-four-year-old male patient developed a high level gastrointestinal obstruction during hospitalization in intensive care unit following a head trauma. He suffered from vomiting and weight loss and was unable to tolerate nasoenteral feeding. Barium radiographs revealed obstruction in the third portion of the duodenum. Upon failure of conservative treatment, laparotomy was performed, which showed compression and obstruction of the third portion of the duodenum by the superior mesenteric artery. A side-to-side duodenojejunostomy performed yielded complete relief of compression symptoms. The patient was symptomless in the sixth postoperative year. Although primary treatment of superior mesenteric artery syndrome is conservative, surgical treatment should be considered in unresponsive patients.