An 81-year-old woman was admitted to the hospital because of abdominal pain and nausea, and diagnosed as having intestinal obstruction. There was no previous history of undergoing laparotomy. Conservative ther-apy could not be curative, and retrocecal hernia was diagnosed by abdominal CT scan. Laparotomy was per-formed under epidural anesthesia. At surgery, a well-defined 1.5cm opening was found, and distal ileum was incarcerated through this opening. We incised the retroperitoneum from the opening, and extracted the incar-cerated ileum. Intestinal resection was not required. Paracecal hernia is so rare that only 34 cases have been reported in the Japanese literature. Furthermore, accurate preoperative diagnosis is very difficult and has been successfully made in only four cases. We report this case with a review of the literature.