Objectives 1. To evaluate the common causes of acute intestinal obstruction in this region. 2. To identify the etio-pathogenesis 3. To evaluate the various modes of presentation. 4. To study the various modalities of treatment in this centre. 5. To evaluate the morbidity and mortality of acute intestinal obstruction Methods Study design : Retrospective Study centre : Department Of General Surgery, Thanjavur Medical College Hospital, Thanjavur, Tamil Nadu, India Study period: May 2007 – November 2009 Duration of study: 30 months Total number of cases studied : 229 Inclusion criteria: both men and women > 12 years of age Exclusion criteria : pediatric patients are not included Conclusion : Majority of acute intestinal obstruction is contributed by small bowel; major cause being external hernias; strangulation rate is comparatively much lower; adhesive obstruction accounts for most; sigmoid volvulus ranking fourth; plain X-ray abdomen is a valuable and minimal investigation before surgery; early diagnosis and early surgical intervention is the key to reduce mortality