Introduction: Bowel perforations are rare conditions following blunt abdominal trauma. Initial clinical examination may be not significant due to delayed peritoneal reaction. The optimal line of management of hemodynamically stable patients with suspected blunt bowel injury, such as mesenteric hematoma, bowel wall edema or fat infiltration, or free fluid for suspected perforation is unclear. Patients and methods:This study done in zagazig university surgical emergency unit between May 2016 and February 2018.We had 81 patients with suspected bowel perforation after blunt abdominal trauma. The aim of the study:To assess the outcomes of initial conservative therapy and selective delayed surgery in patients with unclear intestinal perforation versus urgent surgical intervention. Conclusion:The outcome of delayed diagnosis and surgery is not always very bad The rate of missed injuries after early and initial evaluation may be decreased by the use of advanced technology, and the risk of delayed diagnosis will reduced by improvements of intensive care unit