Abstract: Objective To study the opportunity of intestinal surgical resection for acute mesenteric ischemia. Methods Clinical data about 65 acute mesenteric ischemia patients admitted to our hospital from 2006-01-01 to 2013-10-09 were retrospectively analyzed. Results CT showed intestinal pneumatosis, abdominal cavity pneumatosis and common clinical symptoms, such as acute peritonitis, hematemesis, hemafecia, hemorrhagic ascites, WBC> 18×10⁹/L≥3, indicating that intestinal necrosis did not occur. Conclusion Intestinal pneumatosis and abdominal cavity pneumatosis play an important role in diagnosis of intestinal necrosis. Intestinal surgical resection should be considered immediately when any 3 of peritonitis, hematemesis, hemafecia, hemorrhagic ascites and WBC> 18×10⁹/L are present.