Heterotopic pancreatic tissue, also known as a pancreatic rest, is an uncommon congenital anomaly defined as extrapancreatic tissue located far from the pancreas and without connection via vascular or anatomical means to it. Such tissue may occur throughout the GI tract but has a propensity to affect the stomach and the proximal small intestine. The majority of patients with pancreatic heterotopia are asymptomatic, but when symptoms occur, they can present in a variety of ways. We report a case of a patient whose pancreatic rest presented primarily as dysphagia for solid food and in whom endoscopic ultrasound was used to further define the lesion. There have been only two cases reported of a pancreatic rest causing symptoms of dysphagia. A review of the literature on pancreatic heterotopia as well as the use of endoscopic ultrasound as an aid in evaluation is included.