Acute colonic pseudo-obstruction (Ogilvie's syndrome) is characterized by physical examination and radiologic findings indicative of mechanical obstruction but in which no physical obstructive process can be found. Many factors have been associated with this syndrome which include electrolyte imbalance, systemic infection, drugs, and occasionally, neurologic disease. Reported here is a case of acute colonic pseudo-obstruction which developed in a patient with known Parkinson's disease and was complicated by cecal perforation, yet had a favorable outcome.