Retrograde double balloon entereoscopy is often an endoscopic challenge, among other reasons, due to the difficulty in crossing the ileocecal valve with such a flexible and thin endoscope (distal diameter of 9.8 mm) next to the overtube. In this case an endoloop-assisted polypectomy was performed in a 35-year-old male patient with Peutz-Jeghers syndrome who had a 25 mm polyp at the level of the distal ileum.