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Acute adhesive intestinal obstruction (AAIO) represents one of the most challenging conditions in abdominal surgery and is characterised by high complication and mortality rates. Objective. To examine the interrelationships among proinflammatory mediators, haemostasis system parameters, and fibrinolysis markers in acute adhesive intestinal obstruction. Materials and Methods. Correlations between proinflammatory cytokines (IFN-γ, TNF-α, IL-6), haemostatic parameters (prothrombin time [PT], international normalised ratio [INR], activated partial thromboplastin time [APTT], fibrinogen), and fibrinolysis markers (tissue plasminogen activator [tPA], plasminogen activator inhibitor-1 [PAI-1]) were analysed in 91 patients with AAIO, subdivided into uncomplicated and complicated forms, and compared with 20 healthy controls. Immunobiochemical markers were determined by enzyme-linked immunosorbent assay (ELISA). Written informed consent was obtained from all participants prior to enrolment. All procedures were approved by the Ethics Committee of the Institute and were conducted in accordance with the principles of the Declaration of Helsinki, as revised at the 75th General Assembly of the World Medical Association in October 2024. Statistical analysis was performed using SPSS version 26.0. Quantitative data are presented as the arithmetic mean (M) ± standard deviation (SD) or standard error of the mean (m), as appropriate. The normality of distribution was assessed prior to analysis. Intergroup comparisons were conducted using Student’s t-test for normally distributed variables and the Mann–Whitney U-test for non-parametric data. A p-value of less than 0.05 was considered statistically significant. study was conducted as part of the research plan of the Bukhara State Medical Institute (05.2022 DSc.135), entitled “Development of New Approaches to Early Diagnosis, Treatment, and Prevention of Pathological Conditions Affecting the Health of the Population of the Bukhara Region after COVID-19 (2022–2026)”. Results. Two distinct immune-coagulative phenotypes were identified. IFN-γ correlated positively with INR (r = 0.41) and tPA (r = 0.50), and negatively with fibrinogen (r = –0.36) and PAI-1 (r = –0.50), reflecting enhanced fibrinolysis and reduced coagulation potential. Unlike IFN-γ, TNF-α and IL-6 were associated with elevated fibrinogen and PAI-1 levels, prolonged APTT, and decreased INR and tPA, indicative of hypercoagulability, suppressed fibrinolysis, and endothelial dysfunction. Conclusion. These alterations were most pronounced in the complicated subgroup, suggesting an elevated risk of thrombotic events and ischemic intestinal damage. The findings demonstrate the prognostic value of monitoring coagulation and fibrinolysis markers in AAIO and support their use for early detection of complications and personalisation of antithrombotic strategies.