Superior mesenteric thrombosis is a rare disease of acute abdomen; many risk factors have been identified including arrhythmia, deep vein thrombosis, and hematologic or rheumatologic causes. Image study is more helpful than laboratory test. The standard therapy is anticoagulant (unfractionated heparin or low‑molecular‑weight heparins) administration, but there is still low possibility to need surgery for the complications such as bowel stricture or ischemic bowel disease. We describe the case of acute abdominal pain, the computed tomography showed superior mesenteric thrombosis, and the patient received the therapy with unfractionated heparin and the procedure of superior mesenteric arteriography with intravascular thrombolytic therapy. However, the complication of delayed bowel stricture occurred, which was proved by upper gastrointestinal series. Then, he was cured by surgical intervention with segmental resection of small bowel.