Prompted by the observation of a case of lateral ventral Spigelian hernia complicated by strangulation and manifested by symptoms of small intestine occlusion, the authors describe the anatomo-surgical characteristics of the abdominal site of this pathology. They analyse the various diagnostic and subsequently surgical options available to the surgeon when dealing with this pathology. This is achieved with reference to data reported in the current international literature on the subject. Lastly, the authors provide a series of evocative images obtained during the diagnosis of the patient treated and of the results achieved following surgery and a 1-year follow-up after the operation.