Mesenteric inflammatory veno-occlusive disease (MIVOD) is a rare but increasingly recognized cause of intestinal ischemia. It can be defined as phlebitis or venulitis affecting either the bowel or mesentery, without any evidence of coexisting arterial inflammatory involvement or an obvious predisposing cause. We report the clinicopathological characteristics of five patients who, after presenting with an acute abdomen, underwent exploratory laparotomy and resection of ischemic bowel. The distinctive histopathological characteristics of MIVOD were identified in all five patients. We review the literature on this under-reported condition.