Background:chronic intestinal ischemia is unusual but important cause of abdominal pain. Although this condition accounts for only 5% of all intestinal ischemic events, it can have significant clinical consequences Aim of the Work: the objective of this systematic review was to assess the value of different types of management of chronic intestinal ischemia (Open surgery versus endovascular interventions). PubMed and EBSCOHost electronic databases were methodically searched for English-language articles published be­tween 1996 and 2015.  Conclusion: chronic mesenteric ischemia is a condition characterized by postprandial abdominal pain, which is ascribed to intestinal hypoper­fusion. Patients were frequently malnourished and develop significant weight loss due to sitophobia. Traditionally, open surgery has been the treatment of choice; however, endovascular surgery was gaining wider accep­tance. Based on the data, open surgeries surpass endovascular procedures in terms of symptom amelioration and long-term vessel patency, along with less significant symptomatic recurrence. Patients undergoing open procedures do, however, have a higher rate of complications. Nonetheless, there was no statistically significant difference in mor­tality rates between the two approaches.