Abdominal adhesive disease is a leading cause of adhesive small bowel obstruction. Need for emergency surgery occurred in about 30% of cases despite the effectiveness of medication. Treatment of this disease is characterized by high postoperative morbidity and mortality. Laparoscopic treatment of adhesive small bowel obstruction has been actively introduced in recent years that determines the relevance of this article. Objective — to optimize indications and contraindications for laparoscopic treatment of adhesive small bowel obstruction via a retrospective analysis of single-center data. Material and methods. There were 327 patients with abdominal adhesive disease complicated by adhesive small bowel obstruction in for the period 2011—2017. Surgery was required in 158 patients including laparotomy in 113 (71.5%) cases and laparoscopic procedure in 45 (28.5%) patients. There were 19 (41.6%) men and 26 (58.4%) women. Mean age was 34.5±4.2 years. Causes of adhesive obstruction, indications for laparoscopic surgery, surgical features and postoperative outcomes were analyzed. Results. A retrospective analysis of anamnesis and postoperative result was useful to determine indications and contraindications for laparoscopic treatment of patients with adhesive small bowel obstruction. Indications: previous «small» laparotomy; recurrent disease despite effective medication. General contraindications: severe general somatic condition with contraindicated prolonged increase of intra-abdominal pressure; total enlargement of small bowel loops (over 5 cm); peritonitis; intestinal fistula. Careful selection of patients for laparoscopic treatment of adhesive small bowel obstruction will reduce the incidence of complications, recurrences and mortality rate.