Peritoneal involvement continues to be a rare manifestation of sarcoidosis: its involvement is not always isolated and sarcoid granulomas are also found elsewhere. Peritoneal diseases tend to have an increased incidence in women. Peritoneal involvement presents as ascites, as peritoneal thickening and multiple soft tissue nodules, and can often simulate peritoneal carcinomatosis. We describe a case of a man presenting abdominal pain, nausea, vomiting and a clinical picture of intestinal obstruction, with peritoneal sarcoidosis and abdominal findings suggesting peritoneal carcinomatosis. The diagnosis of sarcoidosis was confirmed by biopsy of the peritoneum during surgical laparotomy. Peritoneal involvement is a rare manifestation of sarcoidosis (less than 30 cases described in English medical literature): to our knowledge this is the first reported case of the disease presenting with an acute abdominal obstruction treated with surgery.