Purpose: The purpose of this study was to determine the prognostic factors and risk scorings that could have an impact on the in-hospital mortality of acute mesenteric ischemia (AMI). Methods: Forty consecutive patients received an operation due to AMI between January 2001 and June 2009. The hospital medical charts and clinical records were retrospectively reviewed. Clinical features, laboratory findings, operative findings, surgical procedure, and prognostic scoring system were collected and assessed as possible the prognostic factors for in-hospital mortality. Results: The overall hospital mortality rate was 32.5% (13/40). In a univariate analysis, significant predictors of in-hospital mortality were decreased mentality (P=0.029), shock at admission (P=0.006), symptom duration (P=0.011), blood urea nitrogen (P=0.029), serum creatinine (P＜0.001), glucose (P=0.004), total bilirubin (P=0.044), aspartate aminotransferase (P=0.001), lipase (P=0.039), pH (P=0.014), bicarbonate (P=0.027), prothrombin time-international normalized ratio (P=0.006), activated partial thromboplastin time (P=0.004), length of remnant bowel (P=0.008), postoperative inotropics (P=0.007), Acute Physiology and Chronic Health Evaluation II (P=0.009), and American Society of Anesthesiologists (ASA) grading (P=0.005). In a multivariate analysis, the variables hyperglycemia (P=0.013) and higher ASA (＞II) (P=0.02) were identified as independent prognostic factors of in-hospital mortality. Conclusion: In conclusion, the prognostic factors in AMI who have hyperglycemia (＞200 mg/dL) and high ASA grading (＞II) are truly associated with very high in-hospital mortality.