In southern China and Taiwan, the fruit of cordia dichotoma is commonly used in cooking and is especially popular in the elderly and vegetarians, who are at high risk of developing a gastrointestinal bezoar. This report describes an elderly vegetarian who presented at our emergency department with persistent abdominal pain. An emergency laparotomy showed an acute intestinal obstruction caused by a bezoar of cordia dichotoma fruit. We concluded that if elderly vegetarians develop an acute intestinal obstruction, bezoars caused by vegetables should be taken into consideration. When conservative treatment fails, a laparotomy needs to be performed to remove the bezoar.