Pathophysiology of paralytic ileus and post-operative colic is described. Management strategies both perioperative and post-operative are discussed. The role of anaesthetic agents and opioids in prolonging ileus is mentioned. Early post-operative feeding is advocated. The use of Cisapride, Metoclopramide and Laxatives is enumerated. Early postoperative small bowel obstruction occurring within 30 days of surgery is described. Pathophysiological causes like adhesion, internal herniation and Inflammation are described. Management strategies with the use of nasogastric tube and guidelines on when to operate for relieving obstruction are given.