Background: Intestinal obstruction is a common abdominal emergency in which timely identification of the site, cause and complications is essential for appropriate management. Contrast-enhanced computed tomography (CECT) provides detailed evaluation of bowel loops, transition points and associated complications. Aim: To evaluate the role of computed tomography in the assessment of intestinal obstruction in a tertiary care centre. Methods: This hospital-based, cross-sectional observational study included 70 consecutive patients aged 18 years or older with clinical suspicion of intestinal obstruction. All patients underwent contrast-enhanced 128-slice multidetector CT of the abdomen and pelvis. CT findings were assessed for the type, anatomical site, cause, grade and complications of obstruction. Imaging findings were compared with plain radiography and ultrasonography, and operative correlation was performed in surgically managed patients. Results: The mean age was 49.6 ± 13.8 years, and 61.4% were male. Small bowel obstruction was the predominant type (70.0%), with the distal ileum being the commonest site (31.4%). Adhesions were the leading cause (25.7%). Dilated bowel loops were identified in 98.6% of patients, while a transition point was identified in 84.3%. CT demonstrated sensitivity of 95.2%, specificity of 87.5%, positive predictive value of 98.3%, negative predictive value of 70.0% and overall diagnostic accuracy of 94.3%. CT altered the initial clinical diagnosis in 34.3% and identified unsuspected complications in 14.3%. Among 50 operated patients, CT findings showed 88.0% overall concordance with intraoperative findings. Surgical and conservative management were undertaken in 71.4% and 28.6%, respectively. Conclusion: Contrast-enhanced multidetector CT demonstrated high diagnostic accuracy and provided valuable information regarding the site, cause and complications of intestinal obstruction. Its findings supported clinical decision-making and preoperati