ACUTE intestinal obstruction remains the most serious common cause for emergency laparotomy today. Although the mortality rate continues to decrease with a better understanding of the pathophysiology, improvement of diagnostic techniques, and greater stress on correction of fluid and electrolyte imbalance, most of these are limited to the so-called "developed" countries or the major centers in other countries. We thought, therefore, that a review of cases from a city in rural India and a comparison with results obtained in the West would be of interest. Material All cases of acute mechanical intestinal obstruction at the Christian Medical College Hospital, Ludhiana, Punjab, from January 1960 to July 1964 were reviewed. Only two particular groups of patients were excluded from consideration—those with esophageal lesions and those with imperforate anus, leaving a total of 147 cases for analysis. Of these 147 patients, 145 underwent surgery. Age Incidence. —The ages of our patients ranged