During the years 1970–1985, 68 patients were operated upon for acute intestinal ischemia due to superior mesenteric vascular occlusion. Survival rate was 24% (95% confidence limits: 14–35), 36% (13–65) surviving superior mesenteric artery embolus, 25% (13–14) surviving superior mesenteric artery thrombosis and 20% (1–72) surviving superior mesenteric vein thrombosis. Twenty-nine patients had intestinal resection (43%; 29–54) with a survival rate of 48% (29–67) and 4 had vascular procedures with 3 survivors. Prodromal symptoms occurred in 46 (68%; 55–78) from 1 to more than 4 weeks before onset of the abdominal catastrophe, an observation which may allow diagnosis and vascular surgery before onset of severe acute inte