Abdominal cocoon syndrome (ACS) is a rare condition in which the small intestine is surrounded by a dense fibrocollagen membrane, often causing intestinal obstruction. Clinical symptoms are diverse and atypical, which makes diagnosis difficult due to the rarity of the disease. The review summarizes the causes, manifestations, imaging methods, pathological features, treatment and prognosis. Recent studies show the association of ACS with tuberculous peritonitis, which requires differential diagnosis. Improved imaging techniques allow better preoperative identification. Surgical treatment is the main method, with an emphasis on basic techniques and management of complications during surgery. The review evaluates the literature to increase awareness, accelerate diagnosis, and support tailored strategies for better patient outcomes.