Brought to you by the Society of Gynecologic Surgeons. Small bowel obstruction is an uncommon complication of uterosacral ligament suspension (USLS) procedures. In this video, the authors present the case of a patient who presented with a closed-loop small bowel obstruction 3 days postoperatively following a USLS procedure. A closed-loop small bowel obstruction is a life-threatening surgical emergency that requires prompt recognition and treatment. Consultation with specialized surgeons familiar with this condition is recommended in the management of this rare complication.