Rare causes of intestinal obstruction include intussusception, volvulus, knotting and internal herniations. This 
is an elderly female patient presented to us on 7th day of intestinal obstruction with only abdominal distension and 
vomiting and no peritonitis. This is found to be an ileoileal knotting without adhesions or loaded mass. Ileoileal 
knotting is a rare condition and ileosigmoid is more common. We are presenting the radiological findings and per 
operative findings of this case because of its rarity.