Small-bowel obstruction is a universal problem which can occur to patients undergoing any type of abdominal operations, which therefore also applies to colorectal surgery. A frequent dilemma in this patient population is the balance between preventing the development of bowel necrosis through a timely operation while also avoiding any unnecessary surgery. The authors have been able to create a predictive model for the need of surgery based on readily available clinical and radiological data, which can be easily applied by all clinicians taking care of patients with small-bowel obstruction.