A 78-year old man visited our hospital because of abdominal fullness, vomiting and a high-grade fever. He had previously had an appendectomy. Physical examination showed no abdominal tenderness. Laboratory data showed severe inflammation, and computed tomography (CT) revealed a dilated small intestine. His symptoms disappeared by conservative treatment with an ileus-tube, but abdominal fullness recurred repeatedly when he began oral intake. At the recurrence, CT examination showed stenosis of the small intestine. On the 21st hospital day, a laparotomy was performed and a stenosis of the ileum about 15cm in length at about 80cm distant from the terminal ileum was observed. A histological study showed disappearance of mucous membrane, inflammatory cell infiltration and fibrosis, suggesting ischemic change. We here report this comparatively rare case of ischemic stenosis of the small intestine.