Background: This case report illustrates a rare and unusual presentation of small bowel obstruction caused by a retained placenta following cesarean section. Case Report: A 38 year old G3P2 multiparous female patient was admitted to hospital with spontaneous rupture of membranes and premature labour on the background of previous successful cesarean and Ventouse deliveries. Following failed attempts at vaginal delivery, the patient underwent an emergency cesarean section. On day one post-operation, the patient developed significant central abdominal pain out of proportion to the surgery, with associated bilious vomiting. A diagnosis of small bowel obstruction was confirmed on X-ray and CT-abdomen and a trial of conservative management failed. A laparotomy was subsequently performed which revealed a retained placenta superior to the uterus causing small bowel obstruction. The retained placenta was surgically removed, which resulted in the resolution of the bowel obstruction. Conclusion: We report an uncommon but important cause of small bowel obstruction secondary to cesarean section retained placenta. Although this is a rare presentation, it is an important differential diagnosis for the surgeon to keep in mind in the post-operative period.