Background: The prompt management of patients with bowel obstruction is essential and requires initial rapid diagnosis and therapeutic intervention. Therefore, the objective of the present study was to explore the clinical presentation and pattern of management of bowel obstruction in Northern Saudi Arabia. Methodology: About 92 files referring to patients presented with obstructive bowel conditions during the period from 2013 to 2017 were retrieved from department of surgery at King Khalid Hospital, Hail, Northern Saudi Arabia. Results: Most of cases of bowel obstruction were found in 2014, followed by 2013, 2016, 2015, and 2017 constituting 22, 20, 20, 15, and 15 cases, respectively. About 76, 52, 69, 58, 13, and 28 of the patients presented with pain, constipation, vomiting, abdominal distention, bowel sound and accompanied disease, respectively. Conclusion: Laparotomy was the most common methods of bowel obstruction management in Northern Saudi Arabia. Many patients with bowel obstruction symptoms can improve without surgical intervention.