The observation of a case of Hodgkin's disease primarily localized in the small bowel and with clinical picture of free perforation prompts the AA. to report the unusual enteric symptoms of this disease and to examine its pathologic and clinical features. Although Hodgkin's disease of the small intestine as a cause of perforation is extremely rare, the AA. describe the prominent frequency of abnormal serum proteins and of long lasting diarrhea with syndrome of florid malabsorption as primary manifestations of ileum involvement. Moreover the AA. indicate that while diagnosis of this peculiar location is rarely made clinically, it requests laparotomy and its confirmed by histologic specimen. The AA. suggests radical surgery and extensive radiotherapy in the treatment of primary Hodgkin's disease of the small bowel.