Preduodenal portal vein (PDPV) is a rare developmental anomaly often reported in pediatric or neonatal populations. We present a unique case of an adult female with PDPV who presented with persistent vomiting due to gastric outlet obstruction and associated partial bile duct injury. Despite the scarcity of reported cases of adult PDPV, our literature review identified 11 cases worldwide. Here, we describe our case along with a comprehensive review of the literature, highlighting the clinical presentation, diagnostic challenges, and management strategies associated with this rare anomaly as discussed by Satish Prasad et al. (Indian J Surg 76(2):137–142, 2014).