Herein, we present an endoscopic repair of iatrogenic duodenal perforation by over-the-scope clipping system (OTSC) and endoclips in an 84-year-old woman that occurred during linear endosonography (EUS) examination. One OTSC and 8 clips were used for repairing the perforation hole. After 3 days in the intensive care unit (ICU) by chest tube and without oral feeding, she was discharged from the hospital at 6. admission day, and she also had an acute coronary attack during 4. hospital day. OTSC and clipping devices are very useful for repair of iatrogenic perforations, especially in older patients who have comorbid diseases and who can not tolerate the surgery.