The incidence of intramural hematoma of the small bowel is rare. More than half of all cases occur as a result of blunt abdominal trauma while cases due to spontaneous bleeding in patients receiving anticoagulants therapy account for approximately 10% of all cases. Another 10% are related to alcoholic pancreatitis or other pancreatic disease, and a few cases have been reported in abused children and after endoscopic biopsy. Although the intramural hematoma of duodenum and/or proximal jejunum were reported frequently, the cases of distal ileum were reported rarely. We have experienced 1 case of the terminal ileal intramural hematoma following blunt abdominal trauma, and clinical symptoms were presented 10 days after trauma as follows: abdominal mass with pain, nausea and vomiting, and constipation. In the physical examination, huge abdominal mass(4 * 5cm in diameter) was palpated in the right lower abdomen, and intestinal obstruction due to intramural hematoma of terminal ileum(about 10cm in length) was noticed in abdominopelvic CT scan. The patient was managed conservatively, and symptoms were relieved 15 days after trauma. As intramural hematoma of terminal ileum has rarely been reported until now, we report its clinical course with a review of the current literature review.