We present a case of complicated Spigelian hernia presented with symptoms of intestinal occlusion, in a 50 years old woman. Spigelian hernia represents 1-2% of all abdominal hernias and can occur anywhere along the semicircular line of Douglas . The patient underwent emergency surgery followed by polypropylene plastic repair. The postoperative course was uneventful and the patient was discharged on day 8 post-intervention in good general conditions. The 2 years follow-up showed no recurrence of the disease. Clinical examination is the foundation of the diagnosis, whereas radiological findings (ultrasonography, TC) allow the exclusion of other pathologies in the differential diagnosis. The preoperative diagnosis is difficult, mainly because of the non-specificity of symptoms as well as the few cases reported in the literature. In conclusion, we remark that the surgery remains the most effective treatment of Spigelian Hernia.