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Background: An obturator hernia is a rare cause of an abdominal wall hernia. Obturator hernia as a cause of small bowel obstruction can be difficult to detect. Delayed diagnosis and treatment of this condition usually lead to a high mortality rate. Case Presentation: We present a case of an 82-year-old lady who presented to the emergency with pain and abdominal distension of 3 days duration. Clinically, she had features of bowel obstruction. Ultrasonography revealed dilated small bowel loops. A contrast-enhanced CT scan of the abdomen and pelvis was obtained which showed a left obturator hernia with features of small bowel obstruction. The patient underwent an emergency exploratory laparotomy which revealed a left obturator hernia with an ileal loop as content. Approximately 40 cm of non-viable distal ileum was resected and also-ileal anastomosis was performed. The post-operative period was uneventful. Conclusion: Obturator hernia, though rare is an important cause of intestinal obstruction. A high index of clinical suspicion is needed especially in emaciated elderly women who present with intermittent medial thigh pain and features of bowel obstruction. Immediate surgery is a life-saving procedure.