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It is always challenging to biopsy a lesion on the uncinate process of the pancreas. Because of the duodenal anatomy and motility the angle of approach and the major vessels of the area (Abdominal aorta, Inferior vena cava SMA and SMV) the tip of the scope is difficult to be positioned perfectly on the target and the needle is difficult to follow the curvature of the organ, to exit or to be visualized echogenically during the biopsy process. This diabetic patient chronic smoker with mild chronic renal insufficiency came with elevated Ca19-9 and Ca 50 abdominal pain and weight loss. He had a CT scan and MRI of the abdomen in another hospital without IV contrast secondary to his renal insufficiency which were both negative for abnormal findings. A mass was found on the uncinate process of the pancreas. FNA biopsy was obtained which was positive for adenocarcinoma of the pancreas.