Following preliminary experimental animal studies showing Doppler ultrasound to be reliable in predicting intestinal viability and to correlate well with subserosal thermistor thermometry measurements, the Doppler technique has been used clinically for intraoperative intestinal viability assessment in colon-esophageal bypasses and colonic resections. Our clinical experience has shown Doppler ultrasound to be far superior to traditional predictive criteria. The presence of good Doppler sounds confirms adequate collateral pulsatile blood flow ensuring viability of the intestinal segment, whereas the absence of Doppler sounds indicates the need for appropriate revascularization. Based on the reliability of Doppler ultrasound, its simple technique and its relative inexpensiveness, we recommend the routine use of Doppler ultrasound for the evaluation of the quality and adequacy of intestinal blood flow in predicting the viability of a segment of the intestine.