Abdominal pain is a common complaint in the pediatric emergency department. Perforation of a peptic ulcer is a rare occurrence in children and is a commonly overlooked etiology. This study presents a case of a previously healthy 16-yearold male presenting with right lower quadrant abdominal pain. Physical examination, laboratory test, and ultrasound results were suggestive of acute appendicitis. The laparoscopy results, which showed a normal appendix, and the following clinical findings, led to the diagnosis of a perforated pre-pyloric ulcer. Valentino syndrome occurs when a patient with a perforated ulcer presents with pain in the right lower quadrant, which mimics appendicitis, a far more common condition.