Intussusception was first described by Paul Barbette in 1674 and is defined as the invagination of proximal bowel into the distal segment producing a telescoping effect. The disorder is relatively common in children and is only rarely associated with an anatomical abnormality. In contrast, fewer than 5% of cases of intussusception occur in adults and most patients have a pathological lead-point. In adults, two-thirds of cases of intussusception occur in the small bowel, while one-third occur in the large bowel. Intussusception of the small bowel is usually due to benign lesions such as lipomas, adenomatous polyps and stromal cell tumors. In the large bowel, 50–60% of patients have a malignant tumor, typically an adenocarcinoma. Adults with colonic intussusception usually present with features of a partial bowel obstruction. Symptoms include fluctuating abdominal pain, nausea, vomiting, rectal bleeding and a change in bowel habit with either constipation or mild diarrhea. Physical examination may only reveal diffuse or localized abdominal tenderness. Plain abdominal radiographs and ultrasound studies are of limited benefit but may show features of a partial bowel obstruction. More helpful information can be obtained from a barium enema X-ray or a computed tomography (CT) scan. Figure 1 shows a contrast enema in a 74-year-old man with colonic intussusception caused by a benign lipoma of the cecum. There is an intraluminal filling-defect in the transverse colon with absence of flow of barium into the proximal large bowel. Figure 2 shows a CT scan in a 42-year-old woman with colonic intussusception secondary to cecal carcinoma. There is a soft tissue ‘target’ mass consisting of an outer intussuscipiens and a central intussusceptum. Other features can include an eccentric area of fat density within the mass and visible mesenteric vessels. As colonic intussusception is associated with a high frequency of malignant tumors in adults, the management is almost always surgical.