Clostridioides difficile (previously, Clostridium difficile) is a frequent cause of hospital-acquired diarrhoea and has shown a rising trend in community-acquired infections as well, with widespread use of antibiotics, among other risk factors. The disease has significant morbidity; a fulminant course may result in death. Rarely, the disease may present with only ileus, with delayed diagnosis, leading to toxic megacolon, colonic perforation and high fatality rates. We report two such patients who improved following specific treatment, leading to full recovery.