Much of the controversy which persists in the treatment of patients with bowel obstruction concerns the decisions of whether and when to advise celiotomy. In view of these and other differences of opinion and continued advances in therapy, the experience obtained in treating obstruction on the Surgical Service of the University of Utah at the Salt Lake Veterans Administration Hospital has been utilized in formulating a rational method of management. Plan of Management Seventy-six patients with 88 episodes of obstruction were admitted during the decade 1948 to 1958. Males predominated 73 to 3, and the ages ranged from 21 to 84 years. This group was limited to those with a history of vomiting, distention, cramping abdominal pain, the roentgenographic demonstration of distended bowel, and/or proof of mechanical obstruction at surgery or autopsy. Patients with obstruction of pylorus or anal canal were excluded from the study. The plan of management adopted