The incarcerated umbilical hernia with intestinal obstruction is rare and associated with some life-threatening complications.We present a case of 85-year-old male patient who was admitted to the emergency department beacause of incarcerated umbilical hernia with intestinal obstruction.After admitted, this patient was diagnosed with incarcerated umbilical hernia with intestinal obstruction, leading abdominal compartment syndrome (ACS), septic shock, acidosis and multiple organ dysfunction.The patient was treated by gastrointestinal decompression, emergency surgery for an incarcerated umbilical hernia, anti-infection treatment and anti-shock therapy.The disturbance of water, electrolyte and acid base had been corrected on the second postoperative day.The dysfunction of coagulation recovered on the third postoperative day.After the abdominal compartment syndrome disappeared on the 4th day and heart-kidney function recovered on the 5th day, the postoperative mobilisation started.And then, the patient began to take food after anus exhausting.Finally, the patient discharged on 10th postoperative day when he recovered.This report indicates that the positive outcome of elderly patients with incarcerated umbilical hernia with intestinal obstruction would be benefit from positive surgery and reasonable perioperative management.