Duodenal masses range from benign to pre-malignant to low-grade malignancy to high-grade malignancy. Many benign and pre-malignant mucosal and submucosal tumors can be managed endoscopically and high-grade malignancies need a pancreatoduodenectomy. However, there are a subset of these masses which are amenable to smaller duodenal resections. Duodenal wedge resections are good for masses, like polyps with high-grade dysplasias or gastrointestinal stromal tumors, on the antimesenteric surface of the duodenum where large margins and lymphadenectomies are not needed. Transduodenal ampullectomy is good for pre-malignant lesions of the ampulla which are not amenable to endoscopic resection. This chapter delineates indications, preoperative workup, surgical technique (including video), and postoperative management of duodenal wedge resections and transduodenal ampullectomy.