A 6.5 year old intact female okapi (Okapia johnstoni) living in Maryland demonstrated clinical signs of lethargy, decreased appetite, thirst, and decreased fecal production. The physical exam revealed slight dehydration, decreased ruminal sounds, and soft feces. Diagnostic tests did not reveal any significant abnormality. She had previously presented with similar clinical signs several times since she was three years old. These episodes where diagnosed as gastrointestinal ileus and were managed conservatively with fluids, non-steroidal anti-inflammatories, electrolytes, pro-motility drugs, antibiotics, and gastroprotectants. She responded well to the treatment and recuperate within a few days during previous bouts of ileus. This last episode was again managed conservatively. However, she did not respond to the treatment and died suddenly. The necropsy revealed a distended abomasum with a focal area of necrosis and a band-like area of necrosis at the junction of the ascending and spiral colon surrounding a small fecal ball. No specific cause of the gastrointestinal ileus was identified.