Intraabdominal infections are common in children, but small bowel abscess in the pediatric age group is rare. This case report shows preoperative diagnosis of small bowel abscess in pediatric emergency department (ED) is difficult, and misdiagnosis can be easily made based on clinical presentations. We report a case of small bowel abscess mimicking the clinical presentation of intussusception in the pediatric ED. Definitive diagnosis of small bowel abscess was finally made with surgical confirmation of an inflammatory collection within the peritoneal space. Patients present with acute abdominal pain should be evaluated for intussusception as well as small bowel abscess.