Background <p>Enterolithiasis is an uncommon condition that can be hard to identify its underlying cause. Jejunal diverticula are also rare (with an incidence of less than 5%) and may be associated with enterolithiasis. It is essential to identify and address the cause of enterolithiasis to prevent recurrence. We herein report typical findings and a course of treatment of true primary enterolithiasis and a jejunal diverticulum, hoping to offer helpful information for clinicians.</p> Case Presentation <p>In this case, a 14-year-old female patient demonstrated a one-year history of intermittent abdominal pain and distension. CT and capsule endoscopy suspected multiple foreign bodies in her intestine. Double-balloon enteroscopy (DBE) revealed a dilated jejunal cavity containing five smooth, hard yellow foreign bodies found a composition primarily of cholate with traces of cholesterol and calcium. The patient was finally diagnosed with true primary enterolithiasis due to jejunal diverticulum. Notably, this patient did not experience obstruction, perforation, or related symptoms prior to endoscopic evaluation, which previously delayed therapeutic surgery as lack of strong indications. The eventual curative surgery confirmed a 7&#xa0;cm dilated jejunal diverticulum.</p> Conclusions <p>Systematic review of the patient’s history and early endoscopic investigation are important for the correct diagnosis and further treatment. What’s more, this case presents typical direct endoscopic images about enteroliths and a jejunal diverticulum. Therefore, we hope it will add some helpful information for clinicians.</p>