SummaryAn 81-year-old woman presenting with intermittent colicky abdominal pain and abdominal fullness for 3 days was admitted to our hospital. The pain was localized in the periumbilical area, without peritoneal signs. A computed tomographic (CT) scan demonstrated a loop of ileum herniating into the space between the pectineus and the left external obturator muscles with an abrupt stenosis of the ileum and dilated small bowel loops. Incarcerated obturator hernia without bowel perforation was diagnosed. Laparotomy with mesh repair of the obturator hernia was performed the next day. The patient recovered well and was discharged on the 6th postoperative day. The literature is reviewed with regard to pathogenesis, clinical manifestation, imaging features and treatment of obturator hernia.