The aim of this study is to evaluate the changing factors related to surgery in intestinal obstruction. The surgical records of patients who were operated for intestinal obstruction at Hacettepe University Medical School during the years 1980-1985 and 2000-2005 were evaluated retrospectively. There were 92 patients in group I and 185 patients in group II. The cause of intestinal obstruction was adhesions in 41.30% of the patients in group I and tumors in 45.95% of the patients in group II (P = 0.0001). Patients with peritoneal carcinomatosis constituted 3.26% of the patients in group I and 27.03% of the patients in group II (P = 0.0001). Abdominal computed tomography was not used in the first group and was used in 60.54% of those in the second group (P = 0.0001). Complications were seen in 40.54% of patients in the second group and in 26.08% of patients in the first group (P = 0.01). During the past 20 years, changes have occurred that were related to causes, diagnostic tools, and nutritional support for patients undergoing surgery for intestinal obstruction. Despite these changes, no changes in length of hospital stay or mortality have been reported. Intestinal obstruction due to peritoneal carcinomatosis seems to be a growing problem.