We present two cases of Bouveret Syndrome managed conservatively with endoscopic holmium laser lithotripsy. Two elderly patients with gastric outlet obstruction caused by gallstone migration into the duodenum through a cholecystoduodenal fistula underwent endoscopic holmium laser lithotripsy. The procedure was performed under general anaesthesia in the operating theatre using a holmium laser probe and a standard gastroscope. In both patients, complete fragmentation of the obstructive gallstone was achieved. Following the treatment, the first patient was asymptomatic and due to multiple co-morbidities, definitive surgery with cholecystectomy was not deemed appropriate. [ABSTRACT FROM AUTHOR]