Objective: To explore the value of 64-slice MSCT in the diagnosis of acute ischemic bowel disease. Method: Fifty-nine cases of acute abdomen of ischemic bowel disease were scanned with 64-slice MSCT and raw data were processed by MPR, MIP, VR and CPR. The imaging features were analyzed. Results: CT features of acute ischemic bowel disease included intestinal wall thickening, abnormal density and enhancement of intestinal wall, dilatation of intestine with gas and liquid, anomalies of mesenteric vascular diameter and density, filling-defect of mesenteric vessel. The filling-defect of mesenteric vessel could be the direct sign for diagnosis. There was obvious difference of enhancement degree between ischemic and normal intestine, which could be the basis for decision of resection range. Conclusion: 64-slice MSCT can serve as the primary method for the accurate diagnosis of ischemic bowel disease and can help to decide the resection range.