Objective: the authors report their experience about treatment of a rare case of intestinal (ileal) obstruction by strangulated obturator hernia. Design: report of 1 case; evaluation of effectiveness of surgical treatment, 2-years follow-up and revision of literature about its clinical presentation and treatment. Setting: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. Interventions: the patient was submitted to curative and radical surgery. Results: resolution of the pathology. Follow up (2 years) negative. Conclusions: obturator hernia is a rare pathology, with difficult and delayed diagnosis: all these character make dangerous this hernia, with a risk of high morbidity and mortality (delayed diagnosis and treatment). The only useful tretment is surgery, espacially in front of intestinal obstruction, with a wide median laparotomy.