Background: Acute small bowel obstruction due to internal hernia is a rare condition. One of the most rare encounters is the Quain hernia (caused by broad ligament defect). Material and methods: A rare case of internal Quain hernia due to a broad ligament defect that caused an acute small intestine obstruction is described. Results: The challenge of diagnosis and the treatment choice is briefly discussed. Conclusions: Patients with broad ligament defect could be clinically very chellenging with not effective RX for the early diagnosis. CT scan with intravenous contrast enhancement could be useful for diagnosis and CT radiologic sign of deviation of the “healthy” uterus to the left or to the right side could be considered like an indirect CT sign of Quain internal hernia. More clinical case studies of treatment options are necessary for further evaluations.