Sciatic hernia organ prolapse through the sciatic foramen is classified as a pelvic floor hernia. A 79-year-old female presented to our hospital with intermittent lower abdominal pain for the previous three months. Abdominal computed tomography revealed that the small intestine had prolapsed through the right greater sciatic foramen, and a right sciatic hernia was diagnosed. There was no evidence of compromised blood flow to the small intestine and blood test results were unremarkable. Elective surgery was performed after considering the risk of comorbidities. During surgery, a hernia orifice was observed in the right greater sciatic foramen of the pelvic cavity. The preperitoneal space around the hernial orifice was dissected and a soft mesh was placed. The small intestine was naturally released from the hernia orifice and showed no ischemic changes. Sciatic hernia is the rarest pelvic hernia, and it is difficult to diagnose because of the various symptoms caused by prolapsed organs. Reports on elective surgery for a sciatic hernia with a prolapsed small intestine are limited. Thus, we report this case with a review of the relevant literature.