A 43-year-old Arabic woman presented with dyspepsia, vomiting, and weight loss for one month. On examination, she had evident weight loss but no other abnormalities. She was diagnosed with pancreatic head cancer and sent to surgery for bypass surgery and a histological diagnosis. This case demonstrates that dyspepsia with alarm features like weight loss and anemia in those over 45 should prompt consideration of pancreatobiliary causes and appropriate imaging if upper GI pathology is not found.