OBJECTIVES: To determine if Serum Intestinal Fatty-acid Binding Protein (I-FABP) is a sensitive marker for necrosis in intussusception among Nigerian children, and determine the correlation between serum titers of IFABP and the length of necrosed bowel. PATIENTS AND METHODS: A prospective study of 50 patients who presented to the children emergency room in LUTH and diagnosed with intussusceptions between May 2015 and April 2016 in addition to 25 age and sex matched controls which had no features of intestinal obstruction and presented for day case surgery. They were grouped into three; 25 patients with necrotic bowel, 25 patients without bowel necrosis and 25 controls. The serum IFABP levels were compared between the patients with confirmed bowel necrosis at surgery and those with no necrosis as well as controls. The cut-off values for the diagnosis of bowel necrosis were calculated using a receiver operating characteristic curve (ROC). In addition, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. RESULTS: 25 patients were diagnosed with necrotic intussusception. The serum IFABP titers were measured with immunoassay and the median found to be significantly higher in these patients compared with titer of those without necrosis and controls (2056.0ng/ml vs. 943.0ng/ml and 478.0ng/ml p=0.0002). Using a cut-off value of 1538ng/ml, the sensitivity, specificity, PPV and NPV were 64%, 88%, 84% and71% respectively. I-FABP titre greater than 1538ng/ml was found for a higher likelihood of necrotic bowel (p=0.002; odds ratio 13.04; 95% confidence interval; 0.618 to 0.891) CONCLUSION: This study showed that I-FABP is a useful marker for discriminating between bowel necrosis in intussusception. It predicts increased likelihood of bowel resectability in intussusceptions hence could aid the surgeon in patient selection for non operative method of treating intussusceptions especially those with delayed presentation who have no signs of peritonitis