A case of intestinal infarction due to multiple ileal carcinoid tumours is presented in which abdominal pain due to intestinal ischaemia was the first manifestation of the underlying tumour. It is postulated that intestinal ischaemia may be of more importance in the production of abdominal pain by carcinoid tumours than has been generally accepted, and that it is the result of functional and structural changes in the around the mesenteric blood vessels, caused by substances secreted by the carcinoid tumour.