Background:  Acute mesenteric ischemia (AMI) is an emergency condition, which is accompanied by fatal complications. Clinical signs and symptoms are often unspecific. In addition, there is no single laboratory test to diagnose acute mesenteric ischemia. Early and accurate diagnosis of intestinal ischemia is important to provide rapid and correct treatment and reduce morbidity and mortality rates. Objective: To determine the clinical predictors of outcome in patients with acute mesenteric ischemia at Emergency Hospital, Mansoura University. Materials and Methods:  This was a prospective study, which was conducted on patients that were admitted to Emergency Hospital, Mansoura University over a year from December 2019 to December 2020. All patients above 18 years old with acute mesenteric ischemia were included while whom less than 18 years old were excluded. Results: this study had 50 patients (21 males and 29 females) with average age of 66 years old. The results showed that majority of the studied cases died, while only 42% (21 cases) of AMI cases survived. Hypercholesterolemia was considered the most frequently reported Co-morbidity followed by HTN, AF and lastly DM and cardiomegaly. There were statistically significant differences as regards co-morbidities (presence of 2 or more co-morbidities). Conclusion:  Acute Mesenteric Ischemia is a serious condition with high mortality rate especially in advanced age and in cases associated with comorbidities, presence of 2 or more co-morbidities, hypertension, hypercholesterolemia, past surgical history increase the incidence of death.