Endometriosis is one of the most common benign gynecological conditions with a prevalence of 6.6% to 16.2% among women of reproductive age in the United States. It is defined as the occurrence of hormone-responsive endometrial tissue outside of the uterine cavity. However, the pathophysiology of endometriosis is poorly understood. Intestinal endometriosis causing large bowel obstruction is rare despite being the second most common extragenital site of endometriotic implantation. In the adult population, intestinal endometriosis is a clinical challenge because it can be mistaken for other acute obstructive diseases, such as colorectal carcinoma. Computed tomography lacks specificity in the detection of bowel wall abnormalities that cause a large bowel obstruction, and endoscopy does not show an intraluminal mass. The gold standard diagnostic procedures are laparoscopy and biopsy, with laparoscopy used for surgical resection of the abnormal tissue if necessary.