Bezoar is undigested material usually found in the gastrointestinal tract that looks similar to feces. Small bowel obstruction caused by bezoar is rare, and is not limited to sex and age. A 61-year-old woman with a history of gastric bezoar presented with epigastric pain. The abdominal computer tomography (CT) scan showed a mottled mass, thickened bowel wall, and a large sized bezoar in the terminal ileum. The upper gastrointestinal panendoscopy examination showed reflux esophagitis. There was omentum adhesion to the distal ileum in the right adnexa which was treated by omentectomy and enterolysis with decompression to remove the bezoar. The patient was discharged from hospital days after the surgery.