Introduction and objectives: Adhesive bowel obstruction is considered one of the commonest causes of intestinal obstruction managed in daily practice, medical schools differ in management plans from conservative to interventional measures with increased morbidity and mortality with recurrent surgical interventions, the aim of our study is to evaluate the therapeutic role of oral water soluble contrast (urographin) in treatment of early adhesive intestinal obstruction.  Patients and methods: All pediatric patients presented at our units in the period from December 2016 to December 2017 by early adhesive intestinal obstruction were included in this study. All patients were given conservative treatment for 24 hours (nothing per mouth, insertion of nasogastric tube, and intravenous fluids). Patients with failure of improvement after 24 hours  were divided to 2 groups in the first group we continued the same conservative measures for 48 hours, in the second group we used single oral dose of urographin. Follow up of the patients was done clinically and radiologically for another 48 hours. Demographic data, type of first surgery, results, complications, and outcome all were collected and statistically analyzed.  Results: The study included 35 patients, oral urographin was used in 14 patients, and we continued traditional measures in 21 patients. The mean duration of hospital stay in the urographin group was 3.36 ± 0.49 while in the conservative group was 6.24 ± 0.89 with P value <0.001. Recurrence occurred in (14.3%) of cases in urographin group and in (33.3%) of cases in conservative group  Conclusion: The period of hospital admission is significantly shorter with the use of oral water soluble contrast (urographin) with fewer incidences of recurrent attacks but it doesn't decrease the incidence of shifting to surgery. The use of urographin is safe with no significant harmful side effects observed.