Congenital Trans mesenteric Hernia (CTMH) is a rare entity of internal hernia that occur as a congenital defect in children due to an error in the rotation of the midget, presenting usually with an abdominal pain, fever and bilious vomiting. However, if left untreated, disastrous outcomes such as acute bowel obstruction and strangulation can take place. Its diagnosis is sometimes challenging to physicians and requires exploratory laparotomy to confirm the presence of a hernia defect. CT scan prior to surgery is seldom needed and may not have a benefit to guide for the exact diagnosis. For treatment, surgical repair, either open or laparoscopic, is the procedure of choice to manage such a condition. We report a case of CTMH in a 3.5-year-old female patient who presented to our hospital with abdominal pain and inconsolable crying. www.opastonline.com J Clin Rev Case Rep, 2019 Volume 4 | Issue 1 | 2 of 2 Copyright: ©2019 Rateb Shahoud. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.