Gallstone ileus is a rare form of mechanical intestinal obstruction. It is associated with high mortality and morbidity in the elderly population. The treatment of gallstone ileus includes more than one surgical option and it is appropriate to determine the surgical technique according to the general condition of the patient.In our case report, we present an 83-year-old patient who was admitted to the emergency room due to nausea and vomiting, was diagnosed with gallstone ileus, and had a cardiac arrest just before surgery. The patient management and the following surgical approach are also explained in detail.