Most cases of Hirschsprung disease (HD) cases are known in newborns or infants. Nevertheless, some cases with mild symptoms are not identified until acute presentations, such as bowel obstruction present in adolescence or adulthood. We reported a 25-year-old male with a history of chronic constipation from childhood presenting with bowel obstruction due to HD. As an emergency operation, the Hartmann procedure was performed to overcome the obstruction. The histological result showed an aganglionic segment, confirming HD. We plan a definitive Duhamel endorectal pull-through surgery three to six months in the future. Adult HD is uncommon, and clinicians should be aware when patients with histories of chronic constipation from a young age present with intestinal obstruction.