Bowel intussusception is rare in adults but common in children. Almost 90% of adult intussusceptions are secondary to a pathologic condition and the clinical picture can be very aspecific and challenging. In this review we discuss the symptoms, location, etiology,characteristics, diagnostic methods and treatment strategies of this rare and enigmatic clinical entity in adults. CT scanning and ultrasonography are helpful for preoperative diagnosis in adult intussusceptions. Currently, abdominal CT scan represents the gold standard with an high accuracy. Most surgeons agree that adult intussusception requires standard surgical intervention because of the high incidence of malignancy. Laparoscopic treatment is also a worthy option for adult intussusceptions. Antegrade and retrograde intussusceptions after gastric bypass surgery are very specific and challenging complications.