To evaluate the role of Multidetector computed tomography in clinically suspected acute small bowel obstruction. Material and methods:The present prospective observational study was on 50 patients with clinical suspicion of acute small bowel obstruction referred to Department of Radio diagnosis, Imaging and interventional radiology from OPD/IPD of C.S.S. Hospital, under the age is of N.S.C.B Subharti Medical College, Meerut. After obtaining clinical history relevant clinical examination was done. CT examinations were done on Philips Ingenuity 128 Slice (MDCT). Imaging and Diagnosis of Small Bowel Obstruction was made as per departmental protocols. We then assessed whether obstruction was present and if present, the level, cause of the obstruction and small bowel feces sign were assessed. Results: 56% of the patients were operated surgically for the management of the SBO while 44% of the subjects were managed conservatively. CT diagnosis predicted true positive and true negative cause of obstruction among 60.71% and 17.86% of the cases while false positive and false negative among 7.14% and 14.29% of the cases. CT diagnosis predicted true positive and true negative finding for the site of obstruction among 57.14% and 25% of the cases while false positive and false negative among 10.71% and 7.14% of the cases. Conclusion: MDCT is highly sensitive and specific in diagnosing cause of obstruction. In addition to primary gut pathology, MDCT can detect various associated and incidental findings which are not suspected clinically.