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A 45-year-old patient with spina bifida and adenocarcinoma of the rectum was treated with a superior hypogastric plexus (SHP) ablation for pain control. The procedure enabled her to reduce opioid consumption, being more clear-headed and functional to be discharged to her residence. The case is presented to highlight the options of neurolytic interventions to manage pain in terminally ill cancer patients. We discuss the options of SHP ablation and justify our choice of approach and the use of a neurolytic agent.