Objective To investigate the diagnostic efficacy between thin-slice spiral CT and X-ray plain film in acute intestinal obstruction. Methods 60 patients with acute intestinal obstruction admitted to our hospital from March 2015 to April 2018 were selected. All patients underwent thin-slice spiral CT plain scan and X-ray plain film examination. The clinical and imaging data of 60 patients with acute intestinal obstruction were collected. The imaging of patients with acute intestinal obstruction were summarized. The diagnostic accuracy and coincidence rate of diagnostic location for acute intestinal obstruction were calculated and compared between thin-slice CT plain scan and X-ray plain film. Results The diagnostic accuracy of thin-slice CT plain scan (100.00%) for acute intestinal obstruction was significantly higher than that of X-ray plain film(90.56%), and the diagnostic coincidence rate of thin-layer CT scan for obstruction site (96.66%) was also higher than that of X-ray plain film. (83.33%), the difference was statistically significant (P<0.05). Conclusion Thin-slice spiral CT and X-ray plain film can effectively display the image features of acute intestinal obstruction. The diagnostic efficacy of thinslice spiral CT is better than that of X-ray plain film for acute intestinal obstruction.