Background: Aim of this study was to assess the therapeutic value of Gastrografin (water soluble contrast medium) in the management of adhesive small bowel obstruction. Materials and Method: This Study was carried out in the Department of General Surgery, AIMSR Bathinda after getting approval from the Research committee, AIMSR and Ethics committee, Adesh University for a period of 18 months. Patients were selected as and when they present to Department of General Surgery, AIMSR Bathinda after applying inclusion and exclusion criteria. After taking informed and written consent, a detailed history, general and systemic examination was done. All the cases presenting with small bowel obstruction were given a trial of conservative treatment unless there was a suspicion of strangulation. Those with a suspicion of strangulation were taken up for laparotomy. Rest of the patients were given oral gastrografin within 2 hours of presentation. In all of them, the conservative trial post-gastrografin was given and followed up for 2- 3 days. The said parameters- clinical improvement, the operative rate, hospital stay duration and resolution of the obstruction were analysed and evaluated. For patients who had conservative treatment for more than 48 hours, surgery was performed if there was no continuing improvement. Parameters used to reach the end point of adhesive intestinal obstruction were clinical improvement (decreased pain, distension, passage of flatus and /or stool, normal intestinal sounds, stool in P/R examination and decreased amount in Ryle tube output) and radiological improvement. Patients’ data that included demographic data, number of previous surgeries, the length of hospital stay and operative rate, were recorded and analysed statistically. Results: In our study, we found operative rate is 18.33% which is at par with results found by Saverio et al (18.5%) in patients given conservative treatment with gastrografin. Also, in our study, the mean hospital stay decreased from 8.55 days (patients who required operative intervention) to 2.73 days (patients treated successfully with gastrografin), which is at par with results found by Biondo et al (hospital stay decreased from 8.5 to 4.1 days). There was no complication or mortality observed that could be attributed to the use of gastrografin in our study. Conclusion: We conclude that the use of gastrografin as a conservative management is a safe and effective method and should be primarily attempted in all patients of adhesive small bowel obstruction as it is beneficial in avoiding surgery in majority of patients (81% patients in our study) presenting with adhesive small bowel obstruction, thereby reducing the duration of hospital stay and cost for the patient as well as reducing the hospital bed occupancy and hospital load. Therefore, administration of oral gastrografin as a nonoperative treatment in adhesive small bowel obstruction is recommended but there is a need for randomised controlled studies with larger sample size for any guidelines/protocols to be established.