Internal herniation through the foramen of Winslow is a rare cause of abdominal hernia. We describe a case in which caecal herniation through the foramen of Winslow was diagnosed using various imaging modalities, including computed tomography and managed operatively through hernia identification, caecal reduction and foramen closure. The literature is subsequently reviewed to highlight previous similar episodes and identify the optimal modalities for pre-operative diagnosis and describe the most appropriate intra-operative management.