Abstract: Objective To study the surgical treatment of acute superior mesenteric artery ischemia（AMAI）. Methods Clinical data about 40 AMAI patients admitted to Chinese PLA General Hospital from 1996 to 2010 were retrospectively analyzed. Results Of the 40 AMAI patients enrolled in this study,35 were diagnosed as mesenteric artery embolism and 5 as mesenteric artery thrombosis.Of these patients,7 underwent balloon expansion stent implantation and 33 exploratory laparotomy（2 underwent resection of mesenteric artery thrombosis,6 resection of mesenteric artery thrombosis and necrotic intestinal canal,2 artificial blood vessel bypass,30 resection of necrotic intestinal canal）.All patients received anti-coagulant therapy after operation.Eight patients died,with a total mortality of 20%. Conclusion AMAI should be suspected in a patient with acute abdominal pain and inconsistent symptoms and signs.Early diagnosis and prompt embolectomy are the key to improving its curative rate.