Abstract: Objective: To evaluate multi-detector row spiral CT (MDCT) in imaging the emergency patients with strangulated intestinal obstruction (SIO). Methods: Twenty-nine patients with SIO confirmed by surgery were included in this study. All patients' clinical data and MDCT data were analyzed. After multiplanar reconstruction and multi window position analysis, CT characteristics of bowel (intestinal cavity expansion, effusion, intestinal wall thickness and density change), CT characteristic changes of mesentery (fuzzy effusion, mesenteric rotation, portal vein changes), image changes within the abdominal cavity (ascites, pneumoperitoneum) and enhanced CT imaging changes (bowel wall enhancement, mesenteric vascular embolism) were analyzed. Results: Of all the 29 participants, 26 cases have luminal dilatation changes, density changes and wall thickening of bowel were found in 18 cases, abnormal air accumulation at intestinal wall and in the portal vein were found in 2 cases, omesentericeffusion were found in 19 cases, stranding sign were found in 11 cases, the whirlpool sign were found in 9 cases, beak sign were revealed in 5 cases, abdominal dropsy were found in 12 cases, 3 cases have mesenteric vascular embolization, intestinal wall enhancement in 5 cases were found after intravenous injection of contrast medium.Conclusion: Careful identification of imaging details of SIO patients using MDCT has a better application value to improve the diagnosis and differential diagnosis in SIO patients.