Abstract Intestinal obstruction due to a rare cause in an adult with chronic pain abdomen. Introduction: The description of patients presenting with small bowel obstruction dates back to the third or fourth century BC, when Praxagora created an enterocutaneous fistula to relieve a bowel obstruction [1]. Midgut volvulus due to intestinal malrotation is a rare cause of intestinal obstruction when occurring in adult life [2].This paper documents the difficulties in reaching an early diagnosis. Discussion: bowel mal rotation can be a mal fixation, malrotation with volvulus and vascular compromise. Usually present in paediatric age group here we present an adult with intestinal obstruction. Surgeries usually done are release of adhesions, prophylactic appendectomy caecostomy and hemicolectomy.