Introduction: Trichotillomania is an impulse control disorder characterized by recurrent hair pulling that may progress to trichophagia and trichobezoar formation. When the hair mass extends into the small intestine, it is termed Rapunzel syndrome and can cause gastrointestinal obstruction. Iron deficiency anaemia is frequently associated with pica and may coexist in affected children. Case presentation: A six-year-old girl presented with severe abdominal pain and vomiting for one day without fever or bowel or urinary symptoms. One vomitus contained a hair clump. The mother reported hair pulling and pica, including ingestion of hair and toothbrush bristles. Examination revealed diffuse abdominal tenderness with sluggish bowel sounds. Haemoglobinwas 10.4 g/dL with microcytic indices, and serum ferritin was 7 .6 ng/mL, confirming iron deficiency anaemia. Abdominal radiography showed absence of the gastric air bubble. Ultrasonography demonstrated an echogenic intragastric mass with short segment small bowel intussusception. Gastroscopy revealed a large trichobezoar extending through the pylorus into the proximal duodenum, causing partial gastric outlet obstruction. Complete endoscopic removal was achieved. Conclusions: Early recognition of trichobezoar in children with abdominal pain, anaemia, andbehavioural risk factors is essential. Combined endoscopic and psychiatric management revents complications and recurrence.