Background: Management of postoperative adhesions-related complications result in a huge workload and cost to surgical health care system. Aim: To address adhesions by reviewing prevalence, diagnosing via imaging/exams, setting severity criteria, and guiding treatment choices for safe, effective care. Patients and Methods: The study involved 60 patients with postoperative adhesive intestinal obstruction at El-Sahel Teaching Hospital. Following clinical and radiological evaluation, patients were categorized into simple and complicated obstruction groups. Twelve patients with suspected complications underwent urgent laparotomy, while 48 with simple obstruction received initial conservative treatment, with delayed surgery if necessary. Result: In our study, we found that no parameter significantly predicted the final outcome, except for patients with recurrent attacks or those who had undergone multiple abdominal operations. These patients were more likely to receive conservative treatment. Despite the risk of undiagnosed bowel complications, conservative treatment proved effective, with a 60% success rate in our study. We recommend a 2-day cut-off for conservative treatment before considering surgery, allowing time for the obstruction to resolve. Additionally, measures to prevent and manage potential complications should be prioritized. Conclusion: Conservative treatment for adhesive intestinal obstruction in stable patients with no strangulation signs is recommended, involving surgical techniques, pharmacological approaches, membrane barriers, and laparoscopic surgery for spontaneous resolution.