We report herein on a case of nonocclusive mesenteric ischemia (hereinafter NOMI) we experienced for which intraoperative endoscopy was effective to determine the therapeutic strategy. The patient was a-70-year old man. As a symptom of vomiting developed during his hospitalization in the department of neurosurgery of our hospital due to head trauma, the patient was referred to our department. With portal gas and intramural emphysema in the small intestine observed on abdominal CT, emergency surgery was conducted due to suspected intestinal necrosis. While the patient was diagnosed as having NOMI due to discontinuous reddening and edema observed in the jejunum, intraoperative endoscopy was performed because the viability of the intestinal canal was not clear. Even though an irregularly-shaped shallow ulcer, reddening and edema were recognized on the mucosal side, resection of the intestine was not conducted due to the observation of lack of necrosis. We report herein on our case with some bibliographic considerations.