Internal hernia is an uncommon type of hernia, trans-greater omental hernia is rarer subtype of internal hernia. The definite treatment of internal hernia is surgical reduction and resection of ischemic bowel. However, it was difficult to diagnose at early stage in patient with non-specific signs and symptoms. The more time we waste in diagnosis or wrong direction of treatment, the worse outcome will be to the patient with strangulated hernia. We present a case of strangulated trans-greater omental hernia with delay diagnosis but successful surgery with reduction and resection of gangrene of small bowel.