State-of-the-art multidetector row CT (MDCT) technology has revolutionized abdominal imaging. The ability of CT to determine if bowel obstruction is present, to localize the obstructive site, to determine degree of obstruction, to diagnose the presence of closed-loop obstruction, and to identify ischemia or perforation of the involved bowel is well established. This article illustrates the usefulness of MDCT in the evaluation of small bowel obstruction and related conditions in adults and emphasizes the benefits of advanced CT applications.