Clostridium difficile infection (CDI) is an important cause of infectious nosocomial diarrhoea. Widespread use of antibiotics has led to a dramatic rise in the incidence of CDI. However, a majority of the CDI cases are either misdiagnosed or undiagnosed because of low clinical suspicion or the use of diagnostic tests with low sensitivity. Although occurrence of diarrhoea in a patient who has recently received antibiotics is an important clue to the diagnosis of CDI, presentation of CDIwith non-diarrheal symptoms like fever, pain abdomen or abdominal distention is known. We report a case of a 65 years old male who presented with acute abdomen in surgical emergency, was diagnosed to have CDI, and was successfully treated with vancomycin.