Recurrent superior mesenteric artery syndrome is an infrequent complication following reconstructive spinal surgery. However, if diagnosis and treatment are delayed, life-threatening dehydration and electrolyte abnormalities may occur. Recent advances in oral and parenteral alimentation have simplified the treatment of superior mesenteric artery syndrome following the early recognition of the characteristic clinical and radiographic presentation. This case report describes the early diagnosis and various methods of conservative treatment of recurrent superior mesenteric artery syndrome following staged reconstructive spinal surgery.