Introduction & Objective: Acute mesenteric ischemia, an important cause of acute abdomen, develops due to a dramatic decrease in intestinal blood supply. According to different series, mortality rate ranges from 60 to 100 percent. This study reviews the clinical features, laboratory data, abdominal radiographs, preoperative ECG, intraoperative findings and treatment results in 32 patients admitted with a diagnosis of acute mesenteric ischemia, from March 1996 to March 2002 to Shohadae Tajrish medical center, Tehran, Iran. Materials & Methods: In a retrospective study we reviewed 32 patients admitted with a diagnosis of acute mesenteric ischemia at Shohadae Tajrish Medical Center, according to the data in their medical records. Results: The disease was twice as common in males as in females, with a mean age of 60 years at the time of presentation. Abdominal pain was the most common symptom followed by nausea, vomiting, obstipation, hematemesis and melena in decreasing order of frequency. On physical examination, most patients had tachycardia. Oliguria was present in 70% of patients and correlated with mortality rate. Shock was also encountered in 10% of cases with a close correlation with mortality. In 30% of patients, peritoneal signs were present which didn’t correlate with mortality. As laboratory findings, leukocytosis was encountered in 95 % of patients which exceeded 20000 / mm3 in 50 % of patients. Eighty percent of patients had acidosis. Overall mortality was estimated to be 75%. Conclusions: According to this study early attention to patient resuscitation, correction of metabolic and homodynamic abnormalities and expeditious surgery are essential steps for successful management of mesenteric ischemia. In selected cases a second look operation is warranted to re-evaluate the viability of the bowel.