The records of 214 patients with acute intestinal ischaemia treated between 1972-1990 were studied retrospectively. The median age of the patients was 74.9 years. A prior history of cardiovascular disease was present in 86% of the patients. Overall mortality of 30 days after the diagnosis was 82%. One hundred seventy-one patients (80%) were operated on. Fifty-one per cent of operations remained exploratory laparotomies. The best results, with a mortality of 51% in 30 days, were achieved in patients who were treated aggressively with bowel resection. Any of the revascularizations (7%) did not turn out to be successful. All the 43 patients (20%) remaining on conservative treatment died. Survivors were usually younger and had less extensive bowel infarction. Thus, the extent and duration of the bowel necrosis were important prognostic factors. To improve the prognosis clinical awareness of the problem and attempts toward early diagnosis should be raised.