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Key content: Bowel obstruction in gynaecological cancers requires a multidisciplinary approach to optimise patient outcomes.Surgery is usually performed with palliative intent. The palliative care team should be involved in patient management especially in the case of recurrent disease.There is no level 1 evidence or national guidance available. Learning objectives: To understand that bowel obstruction in women with gynaecological cancer is rare and seen more often with recurrent disease than primary disease.To appreciate that case selection for surgery is individualised, and that surgery is associated with higher morbidity and mortality rates in emergency cases and following radiotherapy or recent chemotherapy.Most women with gynaecological cancer present with non‐acute bowel obstruction, which is most commonly associated with recurrent epithelial ovarian cancer among gynaecological cancers. Bowel obstruction in irradiated women is less often caused by recurrent cancer.Conservative management includes drug treatments such as opiates, anticholinergics and steroids. Ethical issues: Data on the quality of life of women with gynaecological cancer and bowel obstruction are lacking.Although the goal is palliation in most women, there is no clear definition of ‘successful palliation’.Surgical intervention does not always provide sustained palliation, yet it can contribute to increased morbidity and mortality. [ABSTRACT FROM AUTHOR]