Diffuse nodular lymphoid hyperplasia (DNLH) of the alimentary tract is regarded as a very uncommon finding in the adult population. It is characterized by the presence of numerous visible tiny polypoid masses uniformly distributed through the involved segment, representing an exaggeration of the normal gut-associated lymphoid follicle pattern. The DNLH usually occurs in the small bowel. We report an unusual case of DNLH of the colon in an adult woman who presented with constipation. The DNLH mimics a variety of polyposis syndromes and this may cause difficulties in diagnosis.