Objective: To evaluate the usefulness and reliability of helical computed tomography (CT) for patients with small bowel obstruction. Methods and material: Helical CT findings of 41 patients were evaluated prospectively on the basis of the presence and the cause of obstruction, and the presence of strangulation. Results: In the determination of the cause of the obstruction sensitivity and specificity of CT were 84 and 90%, respectively. Of the 19 patients undergoing surgery, 6 had strangulation and were correctly identified by CT. Conclusion: Helical CT is an accurate method in the detection of small bowel obstruction, especially for evaluating the cause and vascular complications of obstruction.