Introduction: Small bowel obstruction (SBO) is a condition with many well-recognized common causes and a distinct set of symptoms, including constipation, vomiting, and abdominal distension. Recent developments in both imaging modalities and minimally invasive techniques have meant that patients can be more appropriately selected for surgical intervention and that common causes of SBO can be readily identified. Despite these advances, it must be acknowledged that rare causes of SBO are still causing a diagnostic dilemma.Case Report: We are presenting a rare cause of a 45-year-old lady with mechanical bowel obstruction leading to intestinal gangrene caused by a huge uterine fibroid. Conclusion:It is essential that rare causes of bowel obstruction are identified and presented to facilitate their recognition in future to reach better patient's outcome.