Abstract: The present research evaluated the survival benefit of surgery in patients presented with small bowel obstruction with past history of treated cancer. Patients who had previous cancer treatment and underwent laparotomy for cancer related small bowel obstruction between 1992 and 2003 were reviewed. There were 79 patients (median age 62, range 19-91) who had laparotomy in whom small bowel obstruction was caused by recurrent cancer. The primary cancer was colorectal 31, gynecologic cancers 19, melanoma 16 and others 13. Overall complications rate was 35% and mortality was 10%. Median survival was 5 months; patients with history of colorectal cancer had better survival than other diagnoses (median of 7 months v 4 months p = 0.02). in conclusion laparotomy for small bowel obstruction is a worthwhile option in patients with malignant small bowel obstruction, although it is associated with significant morbidity and mortality it offers a reasonable survival in particular for patients with resectable disease.