Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, Skin changes (POEMS) syndrome is a rare and poorly understood paraneoplastic syndrome driven by monoclonal plasma cell dyscrasia. Common presenting symptoms include neuropathy, endocrine dysfunction, skin changes, and volume overload. Here we describe a young female with history of neuropathy who presented to our hospital with abdominal pain and was found to have persistent colonic pseudo-obstruction .She was diagnosed with POEMS syndrome based on the International Myeloma Working Group diagnostic criteria and her intestinal dysmotility was thought to be a consequence of the underlying syndromic condition. To our knowledge, this is the first case of POEMS syndrome presenting with intestinal pseudo-obstruction.