Mesenteric ischemia is a potentially life-threatening medical condition that can arise from one of many different pathways. Acute mesenteric ischemia (AMI) is rare, but a delayed diagnosis can be fatal. Diagnostic imaging and therapeutic endovascular options have been integral in improving outcomes for these patients. While the main causes of AMI include arterial or portomesenteric venous occlusion, there are several lesser known entities that exist and have clinical presentations that may overlap with one another. Nonocclusive mesenteric ischemia (NOMI) generally occurs in critically ill or complex patients and requires a high degree of suspicion. Treatment for AMI must be tailored for the underlying disease process. Increased innovation within the field of interventional radiology has led us to adapt new techniques and technology to overcome these obstacles. In contrast to acute mesenteric ischemia, chronic mesenteric ischemia (CMI) can remain inconspicuous for a long period of time. CMI is most often due to progressive atherosclerosis, but can also precipitate an acute episode of ischemia in the setting of embolic disease. Understanding the underlying pathophysiology, differences in clinical presentation, and imaging can lead to prompt identification and prevent delays in treatment.