Objective To discuss clinical value of multi-slice spiral CT and abdominal X-ray plain film used in the diagnosis on elderly patients with intestinal obstruction, to provide the reference for clinical practices in the future, and to improve the diagnosis level on elderly intestinal obstruction. Methods Sixty patients with elderly intestinal obstruction admitted by the Hospital were selected as research subjects, who were separately subject to multi-slice Spiral CT examination and abdominal X-ray plain film examination, and examination results of two diagnosis methods were compared. Results The accuracy of multi-slice spiral CT in obstruction diagnosis, obstruction position and cause of obstruction was significantly higher than that of abdominal X-ray plain film, and the image resolution and the comfort of patients by multi-slice spiral CT were better than those of abdominal X-ray plain film (p<0.05), the differences were statistically significant. Conclusion Multi-slice spiral CT delivers more important clinical value in diagnosis of elderly patients with intestinal obstruction when compared to that of abdominal X-ray plain film, its images impose certain characteristic, it delivers better intuition and accuracy in determining the occurrence position, cause and degree of obstruction, and it can provide important reference basis for subsequent treatment, posing high value of clinical service.