The graft protective effect of ulinastatin (UTI) against ischemia-reperfusion injury in small bowel transplantation (SBT) was verified with a rat SBT model. This study was carried out to investigate the effects of UTI on the accumulation and adhesion of neutrophils. Twenty-four recipients of rat SBTs were randomly divided into a control group and a UTI group. UTI was injected intravenously into the donor (before harvest of the graft) and into the recipient (50,000 U/kg/d). Variables included graft pathological score; myeloperoxidase content (MPO); expression of intercellular adhesion molecule-1 (ICAM-1) in the graft and plasma concentration of tumor necrosis factor (TNF) in the recipient. The pathological changes of control group grafts were more significant than those of the UTI group. The content of MPO and expression of ICAM-1 in transplanted small intestines were lower among the UTI group as were plasma concentrations of TNF. UTI may ameliorate graft ischemia-reperfusion injury in SBT through decreasing accumulation and adhesion of neutrophils.