A 45-year-old woman had refractory Epstein–Barr virus-associated gastroparesis. Despite lifestyle modification and medication therapy, the patient had recurrent hospitalizations for gastroparesis. Management also included four previous sessions of endoscopic botulinum toxin injection. Despite transient symptomatic improvement, the patient’s symptoms had recurred. She was not a candidate for surgical implantation of a gastric pacemaker, so she was referred for gastric peroral endoscopic myotomy (G-POEM).