Intestinal obstruction (IO) is a common surgical emergency, which should be diagnosed urgently and promptly treated. The cause of IO has changed dramatically during the past century in developed countries. This will highlight the commonest causes of intestinal obstruction in the geographical location of the study which will suggest measures for prevention and treatment of the condition.Aim and Objectives: The study was to determine the incidence of malignant bowel obstruction in patients presenting with intestinal obstruction, admitted in emergency department at a tertiary care center.Materials and Methods: This study was conducted at Osmania General Hospital. It is a Prospective observational study that included 46 patients who were diagnosed to have acute intestinal obstruction features. The patients who are managed conservatively without surgical intervention are excluded.Results: In the present study Malignant bowel obstruction (n=9) is the second most common cause of intestinal obstruction after postoperative adhesions (n=10) at Osmania General Hospital. Malignant bowel obstruction is responsible for 19% of intestinal obstructions. IO, overall has a poor prognosis if there is gangrene of bowel. Conclusion:Patients presenting with IO due to malignancy have more morbidity and mortality and survival when compared to other causes. Early diagnosis of bowel malignancy by screening programmes and monitoring tumour markers will help in early diagnosis and prevent patients.