Intestinal pseudo-obstruction is a rare motility disorder with symptoms and clinical signs of bowel obstruction without a mechanical cause. Symptoms might be acute or chronic. The pathogenesis of acute colonic pseudo-obstruction (Ogilvie's syndrome) is likely to result from an imbalance of the autonomic regulation of the colon. Chronic intestinal pseudo-obstruction (CIPO) may be congenital or acquired. A variety of underlying pathologies, e.g. visceral neuropathy or visceral myopathy are known. Main symptoms are abdominal pain, vomiting, constipation or diarrhoea. Mechanical obstruction, ischemia and perforation should be excluded. Supportive therapy, medical therapy or an intervention (endoscopy, surgery) might be necessary in Ogilvie's syndrome depending on ceacal diameter and duration of distension. Treatment of CIPO depends on the severity of the disease and often needs a multidisciplinary approach.