The authors report their experience of 32 patients operated for acute intestinal ischemia. A massive intestinal infarction was diagnosed in 24 cases. The overall postoperative mortality rate was 72%. The postoperative survival rate was 20% after mesenteric infarction and 42% in patients with limited acute intestinal ischemia. The need for early specific diagnosis is stressed, because the therapeutic options vary widely in relation to different types of acute intestinal ischemia. Furthermore, the basic role of parenteral nutrition in postoperative treatment of short bowel syndrome is underlined.