In the developed world, small bowel obstruction accounts for 20% of all acute surgical admissions. The etiology for majority of these cases includes postoperative adhesions and hernia. However, appendicular knot is exceptionally rare. We report a case of a 65-year-old patient presented to the emergency room with complaint of abdominal pain, distension of abdomen, vomiting, and absolute constipation for 4 days. All the routine hematological and radiological investigations were carried out; the patient underwent laparotomy and was diagnosed with small bowel obstruction due to appendicular knot encircling the terminal ileum.