Objective: To analyze the clinical characteristics and treatment approaches of radiation enteritis with acute bowel obstruction. Methods: The clinical data of 25 patients with radiation enteritis complicated by acute bowel obstruction admitted from October 2006 to March 2011 were retrospectively analyzed. Results: All patients underwent conservative treatment such as catheter intestinal decompression and aggressive nutritional support, and once their emergency conditions were alleviated, selective gastrografin contrast examination of the small bowel was performed via the decompression catherer to reveal the pathologic changes causing obstruction. Of the entire group, 24 cases underwent surgical treatment. Intraoperative findings showed that most radiation injuries occurred in the pelvic cavity or ileum, and there were indistinct borders between intestinal loops as well as abdominal organs, which were even adhered together in a frozen-like state. Thirteen patients underwent resection of obstructing lesion with anastomosis, 10 patients underwent ileocolic bypass anastomosis, right hemicolectomy was performed in one patient, and small intestine intubation and plication techniques were synchronously used in 21 cases. The bowel obstruction was resolved in one patient with nonsurgical treatment. Except for one patient who died of intra-abdominal and lung infection after surgery, 24 of 25 patients (96.0%) were cured. Twenty-three patients were followed up for 6 to 24 months, and the long-term efficacy rate was 95.7% (22/23). Conclusion: Proper conservative treatment can change emergent operation to a scheduled or elective operation for radiation enteritis associated acute bowel obstruction. Resection of obstructing lesion with anastomosis or entero-enteric bypass anastomosis combined with small intestine intubation is the preferred procedure for surgical treatment of this condition.