Although it is a rare occurrence among all pelvic hernias diagnosed the obt
urator hernia continues to be a diagnostic challenge for surgeons today. Th
ese patients, who often have multiple concurrent medical problems, are subj
ect to high morbidity and mortality rates resulting from late presentation
and delayed surgical intervention. The vast majority of patients with obtur
ator hernias are admitted with signs and symptoms of intestinal obstruction
, namely anorexia, nausea, vomiting, constipation, and distension of 2 to 3
days' duration. In this paper, however, we highlight a small subset of obt
urator hernia patients who present without obstructive symptoms and do well
after elective repair. The case reports that follow serve to compare and c
ontrast two very different presentations of this surgical problem.