Introduction: Acute intestinal obstruction travels with interruption in the enteric flow. The clinical condition is composed by abdominal pain, stopping the elimination of gases and faces, abdominal distension and nausea. However, the geriatric population may have atypical clinical features, which makes diagnosis difficult and increases mortality. The most common etiologies of the acute obstructive abdomen in the elderly differ from the adult, because in those there is predominance of neoplasias and diverticular diseases complications. Objectives: Setting the profile of patients older than 60 years with acute obstructive abdomen, the main causes, outcome and treatment.  Methodology: Retrospective study where 60 medical records were analyzed with acute obstructive abdomen. Results: Regarding the main symptoms, it was observed that 86% had abdominal pain, 86% halt of stomach gas and stools, abdominal distention was observed in 51%, 60% showed vomiting, 37% presented other. Among the radiological findings, the most prevalent were: the presence of small bowel loops distension and colonic distension. Regarding the etiology, the main one was the presence of neoplasia, representing 30.2%, flanges and adhesions (23.2%), sigmoid volvo (9.3%), sigmoid diverticulum (7%). The treatment performed was surgical (86% cases). Conclusion: In the present study, neoplasia was the main etiology, followed by flanges and adhesions, differing from the literature in which there’s predominance of flanges and adhesions. The most frequent symptoms were: abdominal pain, halt of stomach gas and stools, vomiting and abdominal distension. Mortality in elderly patients with abdominal pain is high, in this survey was 32%.