Abstract: Objective: This study aimed to evaluate the accuracy of multi-slice computed tomography (MSCT) to locate gastrointestinal bleeding (GIB) based on intestinal distribution combined with mesenteric vascular travel. Methods: The clinical and imaging data of GIB cases diagnosed in our hospital between January 2021 and September 2023 were collected and confirmed by surgery or endoscopy by abdominal CT-enhanced scanning, Two associate chief physicians retrospectively analyzed the thin-slice axial images of MSCT in all cases using the double-blind method, and recorded the presence or absence of GIB. Two observation methods were used to determine the bleeding site; the bleeding site was judged according to the intestinal distribution (group A), and intestinal distribution combined with mesenteric vascular travel (group B). The accuracy of both methods to locate the GIB was compared. Results: There were 130 cases of GIB diagnosed by surgery or endoscopy, and 109 cases were detected by MSCT, with an accuracy rate of 83.85%. There were 71 cases in group A and 85 cases in group B, and the accuracy to locate the bleeding site was 77.98%, with a statistically significant difference (P<0.05). Conclusion: The accuracy of MSCT in locating GIB sites based on intestinal distribution combined with mesenteric vascular travel is better than that based on intestinal distribution alone.