A review of intestinal obstruction in Gonder revealed that small intestinal volvulus in adults is the most common cause of small intestinal obstruction, and it ranked only second to sigmoid volvulus as the most common cause of all intestinal obstruction. Out of 25 patients 23 had primary and the remaining 2 secondary small intestinal volvulus. The secondary small intestinal volvulus occurred in patients both of whom had previous gangrenous sigmoid volvulus that was resected. The disease was predominantly seen in young, adult, male farmers. Though early diagnosis is one of the most important factors in the final outcome of the treatment, the diagnostic accuracy preoperatively is said to be low. In this study diagnosis by exclusion of the common causes of small intestinal obstruction in the region improved the preoperative diagnostic accuracy.