Mirizzi syndrome (MS) is a rare complication of chronic gallstones. Mirizzi syndrome is characterized by a set of symptoms that results from obstruction of the common hepatic or common bile duct (CBD). This may be due to extrinsic compression from an impacted gallstone in the gallbladder neck or cystic duct because of inflammatory changes secondary to chronic gallstone cholecystitis. We present a case of an 86-year-old patient with chronic gallstones who presented with abdominal pain and jaundice. The patient was diagnosed with MS type V after endoscopic retrograde cholangiopancreatography (ERCP). CBD stone fragments/debris were removed, and the patient was referred for surgical intervention for the repair of cholecystoduodenal fistula. MS must be in the differential diagnosis in elderly patients with chronic gallstone cholecystitis presenting with obstructive jaundice. Multiple diagnostic and therapeutic approaches are required to diagnose and manage the different types of MS. We aim to present the case to highlight and raise awareness of MS, particularly in patients with chronic gallstones.