Lumen-apposing metal stent (LAMS) misdeployment occurs in ~10% of EUS-guided gastroenterostomies (EUS-GE). Type III misdeployments (proximal flange in peritoneum) usually require surgery.^1,2 We report the case of a patient with malignant gastric outlet obstruction who experienced a type III misdeployment during EUS-GE. Using EUS/fluoroscopic guidance, a transgastric puncture with a 19G needle allowed guidewire advancement into the malpositioned LAMS and jejunal loop, enabling successful LAMS-in-LAMS placement. Post-procedure imaging confirmed correct lumen apposition and no leak. After resuming a solid diet the patient was discharged. To our knowledge, this is the first report of successful endoscopic rescue of a type III misdeployment, demonstrating its feasibility and potential to avoid surgery.