The aim of the present study was a clinical analysis of small bowel obstruction caused by bezoars surgically treated. Seven patients with small bowel obstruction caused by bezoars were retrospectively reviewed. Two patients had undergone gastric surgery. The symptoms before surgery lasted from 1 to 3 days in the non-ileus tube group and from 9 to 30 days in the ileus tube group. Four patients were preoperatively diagnosed with bezoar ileus, and one had intestinal tumor. The remaining two patients were diagnosed with postoperative adhesive ileus. The operative procedure was evacuation of bezoars for all patients. One patient needed incisions of the small intestine and the stomach for the complete evacuation of bezoars. The site of the small bowel obstruction was the ileum in all patients, and bezoars ranged from 30 to 60 mm in diameter. Morbidity was present in one patient who underwent insertion of ileus tube for a long-term treatment. Small bowel obstruction caused by bezoars is not uncommon in patients without any gastric surgery. It is important, preoperatively and intraoperatively, to examine the entire gastrointestinal tract for the presence of bezoars. When bezoars ileus was suspected, insertion of ileus tube should be avoided.