Introduction: Intestinal obstruction is a very common clinical condition encountered by the General surgeon with a very high morbidity and mortality. While adhesions were considered the commonest cause in the developed countries and external hernias in most developing countries of the world, there has been global variation in aetiology across regions and even within regions. Our aim is to study the aetiology, clinical presentation and treatment in our centre and compare to other studies locally and internationally. Materials and methods: This is a retrospective study carried out at the Federal Medical Centre Makurdi, a Tertiary hospital in Benue state, north central, Nigeria between 2010 and 2014. We retrospectively retrieved and analysed the data of all patients, of all age groups who had laparotomy for intestinal obstruction at the Surgery department. Results: Of a total of 69 patients who had laparotomy for intestinal obstruction, males were 42(60.9%) and females 27(39.1%). The peak ages were 1-10 years (21.7%) and 21-30 years (23.2%). The commonest complaints were abdominal pain 65(94.2%), abdominal swelling 43(62.3%), vomiting 40(58%) constipation 25(36.2%) and fever 24(34.8%). Only 13(18.8%) presented within 72 hours, 17(24.6%) within 4-6 days while majority 32(46.3%) presented between 1-3 weeks. Previous abdominal scar was seen in 22 (31.9%), while 47 (68.1%) had no evidence of a previous scar. The commonest causes of intestinal obstruction were adhesions 24 (34.8%), Typhoid ileal perforation 17 (24.6%), intussusception 9 (13.0%) and colonic tumour 7 (10.1%). There was only 1 (1.4%) case of strangulated hernia. Conclusion: Adhesions and Typhoid ileal perforations are leading causes of intestinal obstruction in our environment with late presentation of case, a common feature. Preventive measures should be encouraged.