Introduction: Previous studies have demonstrated that ischemia-modified albumin (IMA) is a useful marker for the diagnosis of ischemic events. This study aimed to determine the value of plasma IMA in the diagnosis of acute mesenteric ischemia (AMI). Materials & Methods: A total of 21 patients with AMI (I group) and 31control subjects (group II) were included in our study. The diagnosis of AMI was based on the intraoperative findings. Serum IMA levels were measured in I group on admission in hospital. Plasma samples were collected at -18°C. Quantitative IMA detection was performed with ELISA Kit for Ischemia Modified Albumin (Uscn Life Science Inc., China) set, using ELISA UNO (Human, Germany). Results: In all patients with AMI the serum levels of IMA were from 3.6 ng/ml to 235 ng/ml. Serum IMA levels were significantly higher (p<0.0001) in the I gr. vs. II gr. - 63.4 ± 12.8 ng/ml (95% CI: 36.62-90.28) vs. 5.5 ± 0.2 ng/ml (95% CI:5.16-6.01). There was no difference in serum IMA levels between arterial and venous AMI (p>0.05) and duration of AMI (p>0.05). Serum IMA levels were significantly higher (p<0.01) in the AMI with colon involvement vs. small bowel involvement only - 145.7 ± 31.1 ng/ ml (95% CI:47.03-244.4) vs. 41.5 ± 6.8 ng/ml (95% CI:26.76-56.26). The main study limitation is the retrospective detection IMA. Conclusions: IMA is an accurate plasma biomarker for acute mesenteric ischemia, but particularities of the method restricted the use this marker in the early diagnosis of acute mesenteric ischemia.