Paraduodenal hernia is a congenital internal abdominal hernia caused by an abnormal rotation and fixation of the intestine. It is an uncommon cause of small bowel obstruction and rarely presents in children. Chronic abdominal pain and acute intestinal obstruction are most common findings and the symptoms are nonspecific. The mechanism for intestinal obstruction seems to be the constriction of the intestine at the hernial orifice. An acute episode of obstruction may lead to intestinal gangrene due to compression of vessels at the root of the mesentery. Early diagnosis and treatment are essential because of the high morbidity and mortality associated with strangulation. It is often difficult to diagnose preoperatively and, hence, often present at surgery or autopsy. In this study, we present a case of 5 years old with acute intestinal obstruction due to strangulation of a right paraduodenal hernia. Copyright © 2010 by Türkiye Klinikleri.