INTRODUCTION: Craniopharyngiomas are rare, benign brain tumors derived from Rathke's pouch epithelium, typically manifesting with symptoms like visual impairment and endocrine issues. While standard treatment involves surgery and radiotherapy, such approaches are limited in resource-poor settings, resulting in complex management challenges. To describe the occurrence of craniopharyngioma in a young female patient following the surgical removal of an ovarian teratoma, exploring possible associations and clinical implications. CASE PRESENTATION: A 22-year-old woman presented with abdominal pain, distention, visual disturbances, and recent right eyelid ptosis. Her history includes an ovarian teratoma removal, and physical exams revealed hepatomegaly, ascites, and bilateral edema. Imaging showed a suprasellar mass consistent with craniopharyngioma, though histological confirmation was unavailable. Limited resources precluded optimal management, prompting palliative treatment. CLINICAL DISCUSSION: This case highlights the difficulty of diagnosing and managing craniopharyngiomas in low-resource settings with limited advanced imaging and biopsy options. Abdominal malignancy nodules suggest metastasis, a rare but severe complication. CONCLUSION: Craniopharyngioma diagnosis and treatment are challenging in Somalia due to limited resources. Palliative care is often the main option. Strengthening diagnostics and palliative care can improve outcomes.