Intestinal obstruction remains one of the commonest causes of acute abdomen and emergency surgery at KUTH, also in the world. It is a significant cause of mortality and morbidity in all ages. It shows variation in different areas of our country, as well as worldwide. We report the pattern of intestinal obstruction observed in Kigali University Teaching hospital over one year period. This was a one year, retrospective study from January to December 2014, consisting of analyzing medical records of patients admitted with intestinal obstruction at KUTH. All data was entered into a personal computer and analyzed using SPSS (version 16.0) and Microsoft excel 2013. Adhesions was found to be the commonest cause of intestinal obstruction, and has overtaken hernias which was earlier reported in our country. Early diagnosis may lead to better management and outcomes of Intestinal Obstruction.