Acute colonic pseudo-obstruction is a rare complication of gynecological surgery. Despite the complete description of this condition, diagnosis remains difficult and is often delayed. Due to delay in diagnosis and existence of serious comorbid illnesses, morbidity and mortality approaches higher levels. Early recognition of signs and symptoms of this condition and prompt accurate management are vital to prevent serious mortality. Here, we report a case of acute colonic pseudo-obstruction after total abdominal hysterectomy in a patient with known Friedreich ataxia.