Mesenteric ischemia is a rare cause of abdominal pain but is a highly morbid and life-threatening condition. Despite significant improvements in diagnostic and therapeutic options, diagnosis continues to be a challenge and contributes to the high-mortality rate. Open exploration and revascularization should not be delayed if peritonitis or bowel ischemia is present, but with advances in technology and available endovascular devices, endovascular therapy has become a feasible option. It is being used to treat acute mesenteric ischemia in select patients and is now often the standard of care in many institutions for the treatment of chronic mesenteric ischemia. The use of aspiration embolectomy, thrombolytics, and angioplasty with stenting offers very sick patients a less invasive treatment option and may reduce the time to revascularization, reducing bowel ischemia. Additionally, a hybrid approach can offer the best of both open and endovascular treatments, allowing evaluation of the intra-abdominal contents for ischemia while avoiding a traditional arterial bypass. This review contains 16 figures and 65 references Key Words: acute mesenteric ischemia, celiac artery, chronic mesen
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