Omental torsion is a rare cause of acute abdomen and often requires surgical intervention. The etiology is uncertain and the clinical signs mimic acute appendicitis. We present a case of a 34-year-old obese male with no previous medical history.The patient was admitted due to persistent lower abdominal pain. He was initially treated conservatively and underwent surgery because of intractable pain. His clinical diagnosis was acute appendicitis. The torsion of the omentum was found during laparoscopy. Preoperative diagnosis by clinical examination alone is almost never possible. It is possible to make a diagnosis with computer tomography preoperatively. We share our experience with this patient and emphasize omental torsion can be a diagnostic dilemma for acute abdomen, especially lower abdominal pain. Laparoscopy is an excellent
tool to make the diagnosis and is helpful to therapy.