Abstract. The purpose of the study: to study and evaluate the results of surgical treatment of acute adhesive obstruction of the small intestine.
 Material and methods. Of the 49 patients with acute adhesive small intestine obstruction in the past, 83,7 % underwent 1 operation, 14,3 % — 2.
 Results and discussion. After laparotomy, 75,5 % of patients crossed adhesions, 4,1 % had small bowel + bicuspid end ileostomy, 18,4 % had small bowel resection, 2 % had ileotransversoanastomosis, and 18,4 % had simultaneous surgery. Intubation of the small intestine according to the indications.
 Iatrogenic injuries occurred in 12,2 % of patients, postoperative complications - in 18,4 %. 3 (6,1 %) patients died: sepsis (1), multiple organ failure (1), COVID-19 associated pneumonia (1).
 Conclusions. Acute adhesive obstruction of the small intestine is 3,8 % of all acute surgical diseases of the abdominal cavity. The scope of the operation depended on the viability of the small intestine, the possibility of separation of the conglomerate or infiltrate, the choice of method of incubation of the intestine, the presence of simultaneous pathology. This surgical tactic led to 18,4 % of postoperative complications, 4,1 % — relaparotomies, 6,1 % — mortality.