This case report presents a rare instance of primary small bowel mesentery de-differentiated liposarcoma (DDLPS) causing intestinal torsion in a 70-year-old male. The patient presented with abdominal pain and sudden vomiting, and initial examinations revealed no palpable mass or elevated tumor markers. Computed tomography (CT) imaging showed intestinal obstruction due to torsion of the small bowel caused by an LPS tumor. Surgical intervention was performed, and the tumor, which contained atypical adipose tissue and positive immunohistochemical reactions for MDM2, CDK4, and p16INK4, was resected along with a portion of the small bowel. The patient recovered well and was discharged on postoperative day 14 without complications. No recurrence was observed 5 years after the operation. The report emphasizes the importance of considering LPS in the differential diagnosis of bowel torsion and the need for careful management and long-term follow-up due to the high risk of recurrence.This case report presents a rare instance of primary small bowel mesentery de-differentiated liposarcoma (DDLPS) causing intestinal torsion in a 70-year-old male. The patient presented with abdominal pain and sudden vomiting, and initial examinations revealed no palpable mass or elevated tumor markers. Computed tomography (CT) imaging showed intestinal obstruction due to torsion of the small bowel caused by an LPS tumor. Surgical intervention was performed, and the tumor, which contained atypical adipose tissue and positive immunohistochemical reactions for MDM2, CDK4, and p16INK4, was resected along with a portion of the small bowel. The patient recovered well and was discharged on postoperative day 14 without complications. No recurrence was observed 5 years after the operation. The report emphasizes the importance of considering LPS in the differential diagnosis of bowel torsion and the need for careful management and long-term follow-up due to the high risk of recurrence.