Intraabdominal lesions after microsurgical discectomy are rare but potentially life threatening. We report a case of a 47-year-old male who developed abdominal pain after discectomy. An abdominal computer tomography demonstrated free air intraperitoneally, and a perforation of the ileum was found by laparotomy. A resection and primary anastomosis was performed. Patients who experience abdominal pain after discectomy should have an acute abdominal computer tomography performed to diagnose any intraabdominal lesions.