Abstract: Bowel obstruction is a known complication after bariatric surgery especially Roux-en-Y gastric bypass. The known etiologies include internal hernia, jejunojejunostomy stricture, ileus, intussusceptions, superior mesenteric artery syndrome, incarcerated port site hernia, and adhesions. Blood clot is a rare cause of small intestinal obstruction after laparoscopic Roux-en-Y gastric bypass surgery. We elucidate a rare case of small bowel obstruction after Roux-en-Y gastric bypass due to blood clot in about 90 cm distant from ileocecal valve.