While pregnancy after bariatric surgery is safe, the risk of internal hernias can increase during pregnancy due to increased abdominal pressure. Considering the risk to the fetus with undiagnosed bowel ischemia, a high index of suspicion for internal hernia in pregnant patients presenting with abdominal pain should be maintained. We report the case of a 28 year old woman with a history of a laparoscopic Roux-en-Y gastric bypass seven years prior and intussusception at the jejunojejunostomy one year prior who presented with abdominal pain and vomiting while 27 weeks pregnant. Abdominal computed tomography scan demonstrated mesenteric swirling and edema consistent with an internal hernia. She underwent laparoscopic lysis of adhesions, reduction of the internal hernia and closure of Petersen's defect without complications. She recovered uneventfully and was discharged home on postoperative day three.