Paraduodenal hernia, is a type of internal hernia, thought to be formed due to non-fusion of the ascending mesocolon to the posterior parietal peritoneum. Herniation occurs through Waldeyer’s fossa, also known as the mesentericoparietal fossa, with the main contents of the hernia sac being the ileocolic, right colic, and middle colic vessels within the anterior wall and the superior mesenteric artery along the medial border of the hernia. Waldeyer’s fossa, is rare a congenital mesentery defect, found in about 1% of autopsies, which may be discovered as incidental findings at the time of laparotomy or autopsy, or may present as a complication in the form of bowel obstruction, strangulation or perforation. This case demonstrates a 42-year-old female who was found to have a large bowel obstruction secondary to internal herniation of the cecum at Waldeyer’s fossa. Case Summary: The patient presented with sudden onset upper abdominal pain, with associated nausea and obstipation. She was initially tachycardic and physical examination revealed a soft but tender abdomen, maximally over the right upper quadrant without peritonism. On radiological imaging, she had an obstructed internal hernia, which was confirmed, intraoperatively, to be the caecum in Waldeyer’s fossa. Discussion: This case demonstrates the importance of having high clinical suspicion for a internal hernias, including paraduodenal, in the context of bowel obstructions to minimise morbidly such as bowel ischaemia, and mortality. Although imaging provided information about an approximate location of the obstruction in this case, early surgery confirmed diagnosis and facilitated prompt management.