Intestinal pseudoobstruction is an uncommon clinical condition of varied etiologies. Confusion in its characterization and diagnosis often results in delay in diagnosis as well as inappropriate treatment involving repeated surgery. The various aspects and characteristics of intestinal pseudoobstruction are described by representative case reports of three patients treated in our department with a review of the literature. Heightened awareness, understanding of the physiological dynamics and recognition of the spectrum of its clinical presentation and diagnostic modalities should result in more efficacious treatment.