From 1998 to 2002, 369 patients (47.39% M, 52.61% F; mean age 67.9 yrs) were faced in the Authors’ Department due to acute intestinal obstruction. The main reasons of obstruction were adhesions in 281 patients (76.15%), followed by malignant neoplasms of large intestine in 41 patients (11.11%) hernias in 9 patients (2.44%), Ischemic colitis (4.1%), bezoars (2.39%), bile stone (2.71%) and volvulus (1.1%). In this study the clinical and laboratorial investigation, the preoperative preparation and the applied surgical treatment of patients with obstructive ileus are discussed. Also it is stressed the importance of the proper preoperative support, as well as the convenient surgical confrontation of patients.