Introduction: Acute colonic pseudo-obstruction, or Ogilvie syndrome, is a motility abnormality characterised by rapid and progressive dilation of the large intestine. It is seen in the adult population, but rarely in children. To achieves a diagnosis it is fundamental to exclude mechanical obstruction with imaging studies such as computer axial tomography. Clinical case: child of 08 years old with a history of cerebral palsy and anemia came to the pediatric emergencies for abdominal distension and vomiting evolving since a day before admission, all in a context of deterioration in general and feverish condition. The diagnosis of septic shock was made, and radiological examinations confirmed the diagnosis of Ogilvie syndrome. The treatment was conservative with slight clinical amalgamation at start but the symptoms worsened afterwards and the patient die 05 days later. Conclusions: Ogilvie’s syndrome is a rare condition in the pediatric population. Abdominal x-ray plays a crucial role in the diagnosis and management of ACPO, and CT scan help to look for complications. Conservative management in this disease is the initial approach. Interventions should be reserved for when conservative treatment fails.