Background: Acute mesenteric ischemia is a syndrome caused by inadequate blood flow through the mesenteric vessels, resulting in ischemia and eventual gangrene of the bowel wall; it is a potentially life-threatening condition. This study aimed to identify the specificity and sensitivity of using lactic acid serum level in early detection of bowel ischemia. Method:This is a retrospective study conducted at King Abdulaziz University Hospital from August to October, 2016, enrolled all patients admitted with diagnosis of acute mesenteric bowel ischemia. Result: Out of the 192 cases included in the study, 54.2% of them were males, and 45.8% were females, with mean age score 60.9±17.3, 46 patients(24%) were positive for bowel ischemiaand 21 cases out of them (45.7%) had an operative notes Correlated with CT findings. 2 (1%) cases had no correlation with CT findings, and the rest reported no operation. Less than quarter 44 patients (22.9%) reported suffering from only bowl Ischemia without any risk factors or comorbidity, while 34 patients (17.7%) reported a coexisting several risk factors and other diseases. Approximately 107 patients (55.7%) had high lactic acid level. There was significant relation between lactic acid rang and CT scan findings where more than two third of the cases with positive CT had high lactic acid level (69.6% high vs 30.4% normal, p=0.02) Conclusion: Further studies are needed to be conduct on the base of serial measurements of lactic acidosis and on a base combining serum lactate with other biomarkers such as intestinal fatty acidbinding protein to increase the accuracy of diagnosis.