Carcinoid tumours are often difficult to diagnose because of non-specific symptoms, mimicking those of irritable bowel disease of Crohn's disease. The authors describe a 57-year-old patient with clinical and radiological features, suggestive of Crohn's disease, in whom the diagnosis was proved to be a carcinoid tumour involving the terminal ileum. This case report illustrates that ileal carcinoid should be considered in the differential diagnosis of Crohn's disease, particularly in older patients.