Objective: To explore the diagnosis and management of acute mesenteric ischemia(AMI). Methods:The clinical data of 29 patients with AMI treated in our hospital were analyzed retrospectively. Results:All 29 cases presented with initial symptom of severe acute abdominal pain, 13 cases had signs of peritoneal irritation and 5 cases had peritonitis combined with shock. In 20 cases, a definite diagnosis was made by CT. Fourteen cases were cured by anticoagulation/ thrombolytic therapy, 13 patients underwent operatin (7 recovered，6 died), and 2 cases, who refused treatment, died. Conclusions: AMI lacks specific clinical manifestations. Ultrasound, Conventional angiography and mesenteric CT/CT angiography are effective examinations for the early diagnosis of AMI. According to the individual situation of patients, early application of anticoagulation/thrombolytic therapy or operation are essential to reduce the mortality of AMI.