Bowel obstruction following colonoscopy is very rare. We present a case of a 53-year-old female who underwent elective colonoscopy and haemorrhoidectomy. She developed generalized abdominal pain and distension with CT findings suggestive of small bowel obstruction. The patient underwent an emergency laparotomy, which revealed ischemic small bowel which had internally herniated through an adhesional band around cecum. Bowel ischemia recovered following adhesiolysis and the patient was spared from having a bowel resection. She recovered well after 2 days in ICU. We present a very rare case of small bowel obstruction following routine colonoscopy.