Introduction 
Double pylorus or duplication of the pylorus is a rare condition characterized by a gastrointestinal fistula between the gastric antrum and the duodenal bulb. It may be present at birth or developed later. There are few case reports of this condition worldwide. Patients having acquired double pylorus have symptoms related to the underlying cause, such as peptic ulcer disease or other conditions like gastric cancer. In congenital cases, most are asymptomatic. 
Case presentation 
We report a case of a 41-year-old female with a history of epigastric burning-type pain for the past 1 week, which was associated with a single episode of hematemesis. She received treatment with intravenous omeprazole for the same period before being referred to our hospital. The physical findings were unremarkable. She was evaluated with endoscopy, during which a double pylorus was incidentally found. She was later treated with 40mg of pantoprazole orally once daily, with subsequent improvement in symptoms. 
Conclusion 
Double pylorus is a rare and unexpected endoscopic finding. A typical, two-orifice pylorus is observed during diagnostic endoscopy. Medical management of such patients rests on proton pump inhibitors or histamine receptor blockers. Patients refractory to medical management and those with symptoms of gastric outlet obstruction benefit from interventional endoscopic procedures and surgical management for optimal outcomes. Our patient responded for medical management and is currently under follow-up.