Pelvic endometriosis, a common disease of the female genital tract, may also affect the bowel, especially the rectosigmoid colon. Involvement of the small intestine occurs very infrequently. A case of small bowel obstruction caused by ileal endometriosis is reported. Correct preoperative diagnosis is very difficult to achieve. The association of gynecologic complaints with intestinal symptoms in women of childbearing age is characteristic, but the clinical history may be extremely variable. Small bowel roentgenography can be helpful and ultrasound examination offers new diagnostic possibilities. Endometriotic obstruction of the small bowel should be treated by resection of the involved segment.