Abstract: Objective To compare the value of 64-slice spiral CT and digital radiography(DR)in the diagnosis of acute intestinal obstruction in children. Methods Eighty-one children with suspected acute intestinal obstruction were selected. All patients were given DR and CT examinations. The diagnostic accuracy rates of the two examination methods were analyzed by taking surgery or follow-up results as golden standards. Results Among the 81 children patients, there were 58 cases with intestinal obstruction, with a sensitivity of 91.38% in CT and 87.93% in DR, a specificity of 86.96% and 82.61%, respectively, the accuracy rate of 90.12% and 86.42%, respectively, and the consistency Kappa value of 0.763 and 0.679, respectively. McNemar test results showed no significant difference between the two groups(P>0.05). Among 58 children patients with intestinal obstruction, there were 19 cases with adhesive obstruction, 16 cases with intussusception, 11 cases with congenital intestinal obstruction, 5 cases with incarcerated hernia, 3 cases with necrotic enteritis and 4 cases with volvulus, and the accuracy rates of CT and DR for etiology of intestinal obstruction were 91.38% and 75.86%, respectively(P<0.05). Among 58 children patients with intestinal obstruction, there were 48 cases(82.76%)with low intestinal obstruction, 6 cases(10.34%)with high intestinal obstruction and 4 cases(6.90%)with colon obstruction, with the accuracy rates of CT and DR for the obstruction site examination were 94.83% and 82.76%, respectively(P<0.05). Conclusion The accuracy rate of CT in diagnosis of intestinal obstruction is comparable to that of DR, but CT has obvious advantages over DR in the etiology and sites of obstruction.