Eleven cases of inflammatory fibroid polyp of the ileum from Malawi and 1 from Sierra Leone are described. All 12 patients presented with acute intestinal obstruction as a result of an intussusception caused by the polyp. The lesions are characterized by a variable proliferation of fibroblasts and small vessels which may involve the whole thickness of the bowel wall. Tissue mast cells and eosinophils were noted in the polyps. The aetiology of these lesions remains obscure but they appear to be reactive rather than neoplastic. The condition appears to occur more commonly in Malawi than in the United Kingdom or North America and is an important cause of small bowel obstruction in that part of Africa.