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Intestinal obstruction is one of the commonest emergencies encountered in the pediatric age group. It has been recognized from many years as the principle challenge to the diagnostic acumen of pediatrician and therapeutic skill of surgeon. There was a tendency in past for surgeon to anticipate failure in managing pediatric obstruction specially in neonates but scenario has changed gradually in last few decades with improvement in methods of diagnosis, greater understanding of pathophysiology, availability of trained specialised personel, safer anaesthesia, better antibiotics and much improved pre and post operative intensive care1 . Material and Methods: The present retrospective cum prospective study was conducted by reviewing the record of patients admitted with signs and symptoms and diagnosis of intestinal obstruction in Department of General Surgery, S.P. Medical College and Associated Group of Hospitals, Bikaner during 3 years period (January 2010 to December 2012). Summary and Conclusions: Most of the cases (62.9%) presented below one year of age and male to female ratio of 4.4:1 was observed. Congenital pathology most commonly occur in neonatal age group. The high mortality in past was due to delayed diagnosis and referral, parental neglect, low socioeconomic status, anaesthetic complications and lack of neonatal intensive care. But of late the mortality is coming down due to increased awareness, early referral, availability of staff trained in neonatal handling and better antibiotics.