Bilateral hysteroadnexectomy and rectosigmoid resection were successfully employed in a case of acute intestinal occlusion due to endometriotic rectosigmoid stenosis in a 36-yr-old woman. The endometriotic character of the stenosis was only made clear histopathologically. The clinical features of intestinal endometriosis are examined. Its lack of pathognomonic symptoms makes diagnosis difficult and may result in confusion with cancer, even intraoperatively. Ex tempore histological examination is thus fundamental in clinching diagnosis and hence the extent to which intestinal resection is required.