We report an EUS-free LAMS-assisted recanalization of a complete J-pouch afferent-limb stenosis.A 45-year-old man with ulcerative colitis and IPAA had a diverting ileostomy due to a postoperative anastomotic fistula and chronic pouchitis. Endoscopy demonstrated total occlusion of the pouch with no identifiable orifice. Through the stoma injection of saline–methylene blue into the efferent limb resulted in dye appearance within the pouch, confirming a fistulous communication. A guidewire was advanced and a 16×20-mm electrocautery-enhanced LAMS was deployed across the stenosis under fluoroscopic control using a colonoscope. LAMS deployment achieved immediate recanalization of the afferent limb and restoration of pouch continuity. Passage through the stent allowed inspection of the afferent limb and confirmed a patent endoscopic re-anastomosis.