Internal hernias are uncommon causes of small bowel obstruction, with herniation through the epiploic foramen of Winslow being exceedingly rare. They form a minority of cases but carry a high mortality rate due to delays in diagnosis and intervention. We present a case of acute small bowel obstruction secondary to an epiploic foramen hernia requiring emergency laparoscopic intervention. A 67-year-old Vietnamese female presented with acute right upper quadrant abdominal pain following a large meal, associated with nausea and vomiting but no obstipation. Clinical examination revealed dehydration and abdominal tenderness without peritonism. Initial investigations demonstrated a closed-loop small bowel obstruction on contrast-enhanced CT. Laparoscopy identified herniation of jejunum through the epiploic foramen, which was reduced without bowel resection. The patient recovered uneventfully and was discharged on postoperative day 3, with no complications at her 6-week follow-up. The diagnosis of epiploic foramen hernias is often delayed due to their non-specific clinical presentation and absence of classic imaging findings. Early cross-sectional imaging is essential for diagnosis and surgical planning. Prompt laparoscopic intervention can prevent bowel ischemia, minimizing morbidity and mortality. This case highlights the importance of considering rare internal hernias in acute abdominal presentations and reinforces the role of minimally invasive techniques in their management. Epiploic foramen hernias are rare but potentially fatal causes of small bowel obstruction. Surgeons must maintain a high index of suspicion and prioritize early operative management to optimize outcomes. Further studies are needed to delineate risk factors and refine preventative surgical strategies.