In a six-year period, fifty-six cases of intestinal obstruction seen and treated at Asir Central Hospital since its inception were analysed. Adhesions from previous laparotomy scar constituted the commonest cause of intestinal obstruction (57.1%). A distant second is faecal impaction (7.1%). Previously performed appendicectomy is the commonest cause of adhesions causing intestinal obstruction. The interval between surgery and intestinal obstruction varies from one month to three years. The pattern of intestinal obstruction seen in this environment is more similar to those in the western World or advanced countries, than the pattern in the developing countries. This can be explained on the basis of the fact that, even though Saudi Arabia is a developing country, the health care delivery system is similar to those in developed countries. Fifty percent of intestinal obstruction due to adhesions were managed successfully by conservative treatment only. About 15% had a failed conservative treatment and had to undergo operation. In those cases that required exploration and lysis of adhesions, 43.8% also required bowel resection and re-anastomosis.