Abstract Background: Gallstones ileus is small bowel obstruction secondary to gallstones, caused by impaction of gallstones in the intestinal lumen. It is more common in the older population but can affect any age. Case Report: We present a case of a 63-year-old male patient, known case hypertension, presented with complaints of pain and distention of the abdomen, nausea and vomiting. Plain abdominal x-rays showed small bowel obstruction. This mechanical obstruction of the gastrointestinal tract was caused by a gall- stone in the distal jejunum. Conclusion: Gallstone ileus may be initially managed conservatively. A large stone or an elusive diagnosis may necessitate emergency surgery.