Mantle cell lymphoma is a rare and aggressive type of B-cell non-Hodking lymphoma. It can compromise the gastrointestinal tract, sometimes developing an entity known as multiple lymphomatous polyposis. It develops more frequently in males in the sixth decade of life, presenting heterogeneous clinical patterns. The diagnostic is endoscopic with histological confirmation. Currently, the treatment is chemotherapy, reserving surgical exploration of the abdominal cavity for complicated cases with acute abdomen. We present the case of a 51-year-old woman who underwent emergency surgery to treat peritonitis due perforation of a multiple lymphomatoid polyposis, an unreported atypical complication. It is concluded that although it is an extremely rare entity, it is important to include it in the differential diagnosis of complicated multiple colon polyposis.