A retrospective review of 84 cases of intestinal obstruction admitted to the National Guard Hospital over a period of 10 years was carried out. The main causes of obstruction were: post-operative adhesions, 38 patients (45%); hernia, 17 (20%); pseudo-obstruction, eight (9.5%); intussusception, six (7%); malignant obstruction, four (4.8%); inflammatory obstruction, three (3.6%); volvulus, three (3.6%); and others, five (6%). Large bowel obstruction occurred in only 16 patients (19%). Surgical intervention was necessary in 61 patients (73%) while 23 patients (27%) responded to conservative treatment. Post-operative complications occurred in 14 patients (17%). The main complications were: wound infection, chest infection, prolonged ileus and intestinal fistulae. The mortality rate was 3.5%. The pattern of small bowel obstruction in Saudi Arabia is similar to that in the West, while large bowel obstruction is rather uncommon.