During 15 years (from 1959 to 1973) the author observed 753 patients operated upon for acute intestinal ileus; 161 of them aged above 60. An early diagnosis of the condition is difficult due to blurred main symptoms against the background of pronounced age changes and concomitant diseases. The most common non-blastomatous forms are the following: adhesive intestinal ileus (16.8%) and sigmoid volvulus (14.3%). Cancer of the colon with acute symptoms of intestinal ileus was noted in 23.6%. Stomach resection was carried out upon 37.9% of cases. Postoperative complications constituted 34.1% and lethality--30.4%. Elderly and senile patients usually appeal for medical aid rather late, which together with severe concomitant diseases, late surgical intervention, diagnostic and tactical errors admitted in the treatment result in a high postoperative lethality.