The laparoscopic approach to Acute Mesenteric Ischemia is today unclear and less debated (AMI). There are in fact no clinical evidences on this particular focus and only few articles can be found in several databases (pubmed, cochrane library, etc.), and the problem concerns both diagnostic and therapeutic utilization of the procedure. These considerations were already taken into account in 2012 EAES guidelines where the Grade of Recommendation (GoR) of laparoscopy in AMI was low in both diagnostic and therapeutic aspects. According to the new Oxford Classification [1], the use of laparoscopy in patients with suspicious or diagnosed AMI presents a weak GoR.