Introduction: Colonic intussuseption in adults is rare. Presenting symptoms may be atypical, and a misdiagnosis can have serious consequences. Case: A 47-year-old, previously healthy man presented to the gastroenterology clinic with complaints of mild, vague, right-sided abdominal pain, radiating to the right testicle. It was crampy in nature. He had experienced these symptoms intermittently for one month. In the week prior to presenting to us, the pain had gotten worse and almost constant. Along with the pain, there was mild nausea, but no emesis; he was afebrile with regular, non-bloody bowel movements. Physical examination of the abdomen revealed a moderately tender fullness in the right side of his abdomen, but with no guarding of rebound. A complete blood count and electrolytes were normal. A CT scan proved to be diagnostic in finding a large colocolonic intussusception with a giant lipoma identified as the leading point. Colonoscopy revealed a large polypoid mass at the hepatic flexure, with ulcerations at the base and apex. Biopsy showed no evidence of malignancy. He was referred for surgery and underwent a laparoscopic right hemi-colectomy. Surgical pathology confirmed a large submucosal lipoma, measuring 6 x 5 x 4.5 cm, with superficial erosions and ulcerations, in the ascending colon. The patient did well post-operatively, and is currently asymptomatic. Discussion: Intussusception is the telescoping of a proximal segment of bowel (known as the intussusceptum) into a distal segment (known as the intussuscipiens). Adult intussusception (AI) is an entity that differs in almost all aspects, from etiology to treatment, from its pediatric counterpart. While it may be one of the most common causes of intestinal obstruction in children, it remains a relatively rare occurrence in adults, accounting for only 1-5% of bowel obstructions. The rarity of this condition, put together with the multitude of presentations, makes AI a difficult clinical diagnosis. AI presents most commonly as abdominal pain, with nausea, vomiting, diarrhea, and rectal bleeding. CT scans have been shown to have a central role in diagnosis, with some studies displaying 90% accuracy. Here, it was necessary to give rectal contract to be sure of the diagnosis. Although it is sometimes possible to resect lipomas endoscopically, surgery is recommended, in part due to the risk of hemorrhage and perforation, given the size of this lipoma. Conclusion: Adult intussusception is a rare entity, mostly brought on due to an identifiable lesion, which may be benign or malignant. Given the vague, non-specific, and atypical presentation, a very high index of suspicion was required so as to not miss this potentially fatal condition.