Patient with acute appendicitis presenting with intestinal obstruction is rare. Internal herniation as sequelae to acute appendicitis is even rare. A 29–year–old male patient presented with pain abdomen and abdominal distension since 4 days. Clinical findings were diffuse tenderness, lower abdomen guarding with abdominal distension. USG suggested small bowel obstruction and CECT abdomen and pelvis suggested terminal ileal stricture. Intraoperatively, findings were internal herniation of distal small bowel associated with acute appendicitis. Adhesiolysis and appendicectomy was done. Modern diagnostic modalities can guide you in your management of patients but intraoperative findings can leave you surprised.