Since 1978, 21 patients (12 men and nine women) suffering from mesenteric venous thrombosis (MVT) were treated at the Hadassah University Medical Center. The cause of MVT was multifactorial, and in only six patients was the process defined as primary or idiopathic. A preoperative diagnosis of MVT was made in eight patients. Surgical management of the individual patient was based on the extent of the ischemic process, the viability of infarcted intestine and the general condition of the patient. Nineteen patients were operated upon. Exploratory laparotomy without any attempt of intestinal resection was performed upon two patients. Eleven patients underwent resection and primary anastomosis. Second-look procedures were done upon ten patients, and in six, intestinal resection was followed by creation of a double ostomy. The over-all survival rate was reported to be 60 per cent; it was 71 per cent among the patients who were operated upon. The role of second-look procedures in improving survival time is outlined.