Foreign body ingestions often consist of benign objects that will readily pass through the gastrointestinal tract (GI) without necessitating further intervention. While several retrieval devices and techniques are available to the endoscopist, we present a novel method of implementing a needle-knife sphincterotome in the removal of an ingested fishhook embedded in the gastric cardia of a 36-year-old man with underlying schizophrenia. The hook was successfully dissected from the gastric submucosa after several unsuccessful attempts at manual extraction with forceps. To our knowledge, our case represents one in only a handful of other reports of the successful removal of ingested foreign bodies utilizing this method.