BackgroundGlobally, bowel obstruction is the most common cause of surgical emergencies. It remains a challenge to healthcare workers in spite of improvements in management techniques. There is a lack of the study to determine the surgical management outcome and its associated factors in the area of study. Hence, this study aimed to determine management outcome and its associated factors among surgically treated intestinal obstruction patients at Wollega University Referral Hospital, 2021.MethodsFacility-based cross-sectional study was conducted among all cases surgically managed for intestinal obstruction between September 1, 2018 and September 1, 2021. Data were collected using a structured checklist. The collected data were checked for completeness and entered into data entry software and then exported to SPSS version 24 for data cleaning and analysis. Both bi-variable and multivariable logistic regressions were run. P-value < 0.05 was used to declare a statistically significant association in multivariable logistic regression. The odds ratio along with 95%CI was estimated to measure the strength of the association.Result116 (59.2%) patients had favorable surgical management outcome for intestinal obstruction. Male sex (AOR = 3.694;95%CI:1.501,9.089), absence of fever (AOR = 2.636; 95%CI:1.124,6.18), ≤ 48 h duration of illness before operation (AOR = 3.045; 95%CI:1.399,6.629), viable intraoperative bowel condition (AOR = 2.372; 95%CI:1.088, 5.175), having bowel resection and anastomosis (AOR = 0.234; 95%CI:0.101,0.544) were the significantly associated factors of the favorable surgical management outcome for intestinal obstruction.Conclusion and recommendationThe favorable management outcome of patients with intestinal obstruction who were treated surgically in this study was low. Factors like sex, fever, short duration of illness, viable intraoperative bowel condition, and bowel resection and anastomosis were found to influence the surgical management outcome of patients with intestinal obstruction. The patient with intestinal obstruction should seek health care on time. Health professionals have to be skilled and provide appropriate care for the patients to reduce the risk of complications.