A Meckel's diverticulum (MD) is the most prevalent congenital anomaly of the gastro-intestinal tract and the life-long risk for complications is estimated to be around 4%, mostly resulting in bleeding, obstruction, diverticulitis or intussusception. Although rare, about 3.1-5.1% of the complications are due to malignant evolution of the MD. Case: We present a 50-year old patient with progressive subobstructive symptoms leading the diagnosis of a complicated MD. Peroperative findings were suggestive for malignancy and the histopathological samples confirmed the presence of a metastatic adenocarcinoma, arising from the MD. Conclusion: This case illustrates a rare, malignant complication of a MD. This finding is of utmost clinical importance because the diagnosis may be challenging and early detection may improve the outcome of these patients. The clinician should be aware that malignant evolution of a MD exists and should be excluded in complicated cases.