Introduction: Endometriosis isthepresence of endometrial cellsoutsidetheuterinecavity, a benigndiseasethataffectsbothwomenduringthereproductiveperiod and those in postmenopause. Extragenitalpelvic endometriosis describes endometrial lesionsthatinvolvepelvicorganssuch as therectum, sigmoid, and bladder.Clinical case: femalepatient, 71 yearsold, presents abdominal pain and changes in bowelhabits of 3 months of evolution, isadmittedwithwithclinicalpresentation of intestinal subocclusionof 5 days of evolution. Imagesreveal distal airlesswithhydro-air levels. Surgicalconduct, exploratorylaparotomy, inflammatorylesion in therectosigmainvolvingthesmallgut. Hartmann surgeryisperformed. Thepathologicalstudyreportscolonicwallwithfoci of endometriosis and adherence to theovarian and tubalparenchyma.Conclusion: Colonic endometriosis can presentwithobstruction and be difficult to differentiatefromother causes of largebowelobstruction, such as Crohn'sdiseaseorneoplasms. Sigmoid colon involvementisthemostcommon. Preoperativediagnosis duringemergencyisdifficult and dependsonthehistologicalconfirmation of theresectedspecimen.