Mesenteric ischemia is a life-threatening vascular emergency with high mortality rates. Mean platelet volume (MPV) has been shown to be closely related to platelet activation. We investigated whether MPV was associated with outcome of acute mesenteric ischemia (AMI). Sixty-one patients who were operated for AMI were retrospectively evaluated. Patients were divided into two groups: survivors and nonsurvivors, according to the outcome, and the two groups were compared in terms of MPV levels and other prognostic factors. Urea, creatinine, alkaline phosphatase, amylase, gamma-glutamyl transferase and MPV levels were significantly higher in nonsurvivors, when compared to that of survivors. In addition, hypertension, atherosclerotic heart diseases and rhythm disorders were statistically significant risk factors for mortality. AMI is an uncommon but highly lethal surgical emergency. Our results indicate that an elevated MPV is associated with a worse outcome in patients with AMI. Copyright (c) 2015 Wolters Kluwer Health, Inc. All rights reserved.