Background: A prospective study of 50 patients presented in emergency department with features suggestive of intestinal obstruction which is a common cause for acute abdomen, Aim: To evaluate role of MDCT in diagnosis of bowel obstruction. Methods: 50 patients presented with symptoms and signs suggesting primary diagnosis of intestinal obstruction between July 2017 to June 2019, 24 patients were males and 26 females, with the mean of 46.5 years old. All of them underwent MDCT study on abdomen and pelvis with coronal and sagittal reformatted images to assess presence of bowel obstruction. Results:  40 patients have provisional diagnosis with MDCT as intestinal obstruction, 32 cases were taken for exploratory laparotomy and 8   patients were managed conservatively. 31\32 patients approved to have intestinal obstruction while one case not approved with sensitivity and specificity 100% and 91.4 % respectively. The small bowel is involved in (20\39) 51.28% of cases, whereas large bowel   is involved in (19\39) 48.71% of cases. In 8 patients, the sign of ischemia seen on MDCT scan and confirmed on exploration, so sensitivity and specificity in diagnosis of bowel ischemia was 100%. Eight cases diagnosed with MDCT as closed loop, 7/8 approved intra -operatively, only one 6case not approved. so sensitivity and specificity of MDCT in diagnosis of closed loop was (100 % and 96.1 %) respectively. Conclusion: MDCT is highly sensitive and specific in determining the presence or absence of bowel obstruction.