Objective To study the diagnostic value of CT small bowel imaging in the location and etiology of intestinal obstruction. Methods 46 patients with intestinal obstruction which confirmed by surgery and pathology in our hospital from September 2012 to September 2014 were selected as the research objects. The GE Lightspeed 64- slice spiral CT instrument made by America was adopted to carry out plain scan and three phase enhanced scan. The detection rate of MSCT in diagnosis of intestinal obstruction and the value in judging the cause and the location of the obstruction were analyzed. Results 46 cases of patients with intestinal obstruction were detected and the detection rate was 100%. 27 cases of transition zone were clearly displayed. 46 patients were with visible expansion (longer than 2.5cm), pneumatosis and hydrops; Pathology proved that the number of high and low obstruction were 23 cases. The results of CT examination showed high obstruction in 27 cases, low obstruction in 19 cases, 4 cases of low obstruction misdiagnosed as high obstruction and the accuracy of localizing obstruction was 91.30% (42/46); 16 cases were diagnosed as adhesive intestinal obstruction by surgery and pathology, 6 cases as intussusception intestinal obstruction, 4 cases as mesenteric vascular obstruction, 2 cases as traumatic intestinal obstruction, 1 case as internal hernia, 2 cases as volvulus, 12 cases as intestinal obstruction caused by neoplasm and 3 cases as tumor compression type obstruction. There were 12 cases of adhesive intestinal obstruction, 7 cases of intussusception intestinal obstruction, 4 cases of mesenteric vascular obstruction, 2 cases of traumatic intestinal obstruction, 3 cases of volvulus, 16 cases of intestinal obstruction caused by neoplasm and 3 cases of tumor compression type obstruction diagnosed by CT. 5 cases were misdiagnosed. 4 cases of adhesive intestinal obstruction were misdiagnosed as neoplastic intestinal obstruction and 1 case of internal hernia misdiagnosed as intestinal volvulus. The accuracy of etiological diagnosis was 89.13% (5 / 46). Conclusion The accuracy of CT small intestinal imaging in the diagnosis of intestinal obstruction is high and it is of high accuracy in differentiation of the etiology and location of intestinal obstruction, which can provide reliable basis for later treatment and followup.