Abstract Complete sigmoidal obstruction is a rare complication of cesarean section. The diagnosis is readily made clinically and substantiated by roentgenologic studies. Early in the process nonsurgical treatment may be effective. Late in its course, surgical decompression by colostomy or cecostomy is imperative to prevent cecal perforation, which is associated with a very high mortality. Organic disease of the descending colon, sigmoid or rectum must be ruled out before closing the colostomy or cecostomy.