We describe a patient who was treated for mis-dignosed Crohn’s disease for six years prior to presenting with an abdominal crisis. Computer tomography (CT) imaging then demonstrated classical features of a mesenteric carcinoid tumour. At laparotomy, infarcted small bowel secondary to a carcinoid tumour with mesenteric extension around the terminal ileum was found. We propose that where no histological diagnosis has been made, early CT scanning should be considered to differentiate between Crohn’s disease and other possible diagnoses, specifically carcinoid.