Perioperative management of patients with peripheral vascular disease is challenging. Extensive atherosclerotic involvement of the vascular system including coronary, renal, mesenteric and cerebral vessels predisposes it to increased perioperative mortality and morbidity in the form of myocardial infarction, congestive heart failure and renal failure. Hence present study was planned to evaluate the Intestinal fatty acid binding protein (I-FABP) as a marker for acute intestinal ischemia in patients from Bihar region. The present study was planned in Department of Gastrointestinal Surgery, Indira Gandhi Institute of Medical Sciences, Patna, Bihar. Total 20 cases of acute intestinal ischemia were enrolled in the present study as case patients. The more 20 patients without any complication were selected in control group patients. The study was conducted from May 2016 to Jan 2017. The data generated from present study concludes that Intestinal ischemia is a surgical emergency and warrants immediate surgical intervention. Quicker diagnosis aided by serum I-FABP levels will enable us to intervene in such patients quickly reducing morbidity and mortality among patients. I-FABP levels may be used to diagnose such fatal pathologies. Further studies with wider series are needed in order to investigate the diagnostic value of I-FABP in patients with abdominal pain.