Acute colonic pseudo obstruction (ACPO), also known as Ogilvie syndrome, a rare entity associated with massive dilatation of the colon in the absence of any obstruction. Increase in luminal pressure of dilated colon causes bowel ischemia followed by perforation and rupture. Bowel ischemia and necrosis is associated with severe morbidity and mortality. We are reporting 4 cases of ACPO in post-caesarean patients diagnosed and managed at department of OBG (Vanivilas hospital), Bangalore medical college and research institute, Bangalore. We managed two patients conservatively and two patients underwent emergency laparotomy and caecostomy and hem-colectomy.