Objective: To describe our experience in the laparoscopic approach for small bowel obstruction (SBO) with long term follow-up. Materials and Methods: Retrospective analysis including all patients who underwent laparoscopic surgery for adhesive SBO between 2005 and 2020. Results: 94 patients were included, with a median age of 49 years old (16-104); 71.3% had prior abdominal surgeries and 19.1% a previous episode of SBO. Thirty six patients (38.3%) underwent surgery within 24 hours of admission. Bowel resection was needed in 14.9% (n = 14). Conversion rate to open surgery was 35.1%. Ten patients (10.6%) had postoperative complications, three classified as major morbidity. Two reoperations and no mortality were reported at 30 days follow-up. Median follow-up was 67 months (1-214). In long term follow up, 8.5% (n = 8) were readmitted for a new SBO episode. Discussion: the increasing experience in laparoscopy and its well-known advantages make it an attractive option in the surgical management of small bowel obstruction (SBO), probably diminishing the recurrent episodes in the long-term follow up, in a selected group of patients. Conclusions: The laparoscopic approach is safe and feasible for acute bowel obstruction in selected patients, with acceptable rates of recurrence in long term follow up.