Endometriosis is the presence of ectopic endometrial tissue outside the uterine cavity. It is a well-known cause of chronic pelvic pain and infertility in women. Endometriosis of the appendix is rare and may present with acute or chronic abdominal pain. Preoperative diagnosis is difficult. The definitive diagnosis is usually established following histopathological examination of the appendix. The authors report a case of ileus at the ground of adhesions formed due to appendiceal endometriosis clinically presented with recurrent attacks of abdominal pain in the eight month of pregnancy after laparoscopic removal of the ovarian endometriosis.