An offset gooseneck ball hitch has a shank received in a vertical OEM gooseneck socket and an offset hitch ball provided on an offset body. A frame connection structure allows the offset gooseneck ball hitch to mate into at least two different OEM puck spacings relative to the vertical OEM gooseneck socket. The frame connection structure preferably includes a driver side transverse anchor assembly having a driver side anchor, a passenger side transverse anchor assembly having a passenger side anchor, and a longitudinal connection weldment securable to the driver side transverse anchor assembly, to the passenger side transverse anchor assembly, and to the offset body. The offset body preferably includes a pivot handle for securing the shank in the vertical OEM gooseneck socket, and the anchors preferably each include a T-bolt with a handle for pivoting the T-bolt within the OEM puck socket.