Primary malignancies of the small bowel represent only 2.4% of all gastrointestinal malignancies [
1]. Adenocarcinoma is the most common malignancy of the small bowel, comprising about one-third of all small bowel malignancies [
2]. The most frequent location for small bowel adenocarcinoma (SBA) is the duodenum (52%-55%), followed by the jejunum (18%-25%) and the ileum (13%), and not otherwise specified (10%-14%) [
2,
3]. Non-specific symptoms and the lack of useful diagnostic methods results in a delayed diagnosis of SBA. The ratio of SBA diagnosed at stage I, stage II, stage III and stage IV has been reported to be 4%-12%, 20%-27%, 26%-39% and 32%-35%, respectively [
2,
3]. The five-year survival rate is 26%-30%, with a median survival of 20 months [
2,
3]. Although curative resection is the most important prognostic factor, 67% of patients with SBA receive curative resection [
2,
3]. Even after curative resection, 39% develop recurrence [
3]. The usefulness of adjuvant chemotherapy after curative resection or palliative chemotherapy for advanced or recurrent SBA remains unconfirmed because of the absence of a randomized control trial (RCT) for SBA [
4,
5]. Only a few controlled clinical studies for SBA treatment have been reported [
6,
7] but the effectiveness of chemotherapy for advanced SBA has been shown by retrospective studies [
8]. Aggressive surgical intervention seems to be effective for some cases of advanced or recurrent SBA [
9,
10]. We report on a patient who had peritoneal metastasis from recurrent SBA after curative surgery and adjuvant chemotherapy. Cytoreductive surgery and palliative chemotherapy were employed for this patient.