Incarcerated Spigelian hernia is a rare cause of abdominal pain requiring emergency surgery. It occurs in the lower abdomen between abdominal musculature in the region of Spigelian aponeurosis. On the basis of incidental findings in laparoscopy the frequency of this hernia is less than 2%. Spigelian hernias are often completely symptomless, but they are associated with the risk of intestinal incarceration. Owing to its rare occurrence, incarcerated Spigelian hernia is difficult to diagnose, which may delay the treatment.