Background: Intestinal obstruction is one of the common acute abdominal emergencies in surgical practice. Early recognition and prompt intervention can prevent irreversible ischemia and thereby decreasing the mortality and long term morbidity. Aim : To find out the Incidence, causes, presentations and management of patients with intestinal obstruction at the surgical department, Govt. Chengalpattu Medical College. Methodology: This study was conducted at Government Chengalpattu medical college and hospital for a period of two years from June 2014 to June 2016. It is a descriptive study that included patients who were diagnosed to have Acute Intestinal Obstruction based on clinical, biochemical and radiological features. The patients who were managed conservatively without surgical intervention were excluded. Other investigations for fitness for anaesthesia i.e, complete blood picture, electrolytes, urea, creatinine, ECG were taken. Final diagnosis was made at exploratory laparotomy. The operative details, e.g, cause, site of obstruction and operative procedure were recorded. Biopsy was taken where required for histopathological confirmation. Postoperative complications and outcome were noted. Results: Number of patients admitted with Intestinal Obstruction were 100. Of the100 patients, 83 were due to small bowel obstruction and 17 were due to large bowel obstruction. Most common age group affected was between 51 to 60 years. Males were more commonly affected. Obstructed inguinal hernia (32%) was found to be the most common cause followed by adhesive obstruction (26%). Most of the cases presented with abdominal pain (94%), vomiting (69%), constipation (58%) and abdominal distension (52%). Most common surgical procedure was hernia reduction and repair followed by resection and anastomosis / colostomy. Most of the cases recovered without any complications (76%).