Background: Intestinal obstruction is a common surgical condition, yet the role of gender in its distribution and clinical outcomes remains underexplored. Objective: To analyze the gender distribution in patients presenting with intestinal obstruction and to assess gender-specific patterns in subtypes and interventions. Methods: A prospective study was conducted at Shyam Shah Medical College and Sanjay Gandhi Memorial Hospital, Rewa, from September 2022 to March 2024. A total of 385 patients diagnosed with intestinal obstruction were included. Gender-based analysis was performed for demographic details, subtypes of obstruction (subacute and acute), and management approaches. Results: Of the 385 patients, 262 (68.05%) were males and 123 (31.94%) were females, with a male-to-female ratio of 2.13:1. Among patients with subacute intestinal obstruction (SAIO), 144 (65.94%) were males and 74 (34.05%) were females. In acute obstruction, 120 (71.92%) were males and 47 (28.07%) were females. Surgical intervention was more frequently required in males (42.37%) compared to females (28.45%), with a statistically significant difference (p < 0.0001). Conclusion: Intestinal obstruction is significantly more prevalent in males, who also have a higher likelihood of requiring surgical intervention. Gender-based assessment is crucial for improving diagnosis and treatment protocols.