Familial Mediterranean fever is an autosomal recessive disease characterized by recurring inflammatory attacks of synovial membranes. More than 95% of patients show peritoneal involvement which mimics acute abdomen and can sometimes cause unnecessary surgical intervention. The authors present two patients with the diagnosis of familial Mediterranean fever who underwent surgery because of rare abdominal complication of the disease. Two patients with the diagnosis of familial Mediterranean fever underwent laparotomy, and segmental small bowel resection was done because of the necrosis. Adhesive intestinal obstruction with associated bowel strangulation and volvulus is a rare complication of familial Mediterranean fever, and this life-threatening emergency must be kept in mind.