Objective：To analyze the clinical manifestations，diagnosis，treatment and prognosis of primary small bowel adenocarcinoma （PSBA）. Methods：The clinical data and survival analysis of PSBA in 31 cases were retrospective analyzed. Results：Among the 31 cases，17 cases were male，14 cases were female；the median age was 67 years；mainly originated from duodenum and manifested as anemia. Preoperative diagnosis rate was 38.7%；the proportions of stagesⅠ，Ⅱ，Ⅲand Ⅳ were 9.7%，22.6%，35.5% and 32.2%，respectively. Curative resection was performed on 20 patients；palliative surgery was performed on 5 patients；11 patients re－ceived chemotherapy. The median survival time was 22 months and the 5-year survival rate was only 19%. The median survival time of patients over 65 years，with stageⅢ-Ⅳ or with local invaded lymph-node ≥4 was respectively lower than that of patients below 65 years，with stageⅠ-Ⅱor with local invaded lymph-node ≤3 with statistically significant differences（P <0.05）. However，in terms of gender，pathological grade，primary site，tumor maker and chemotherapy after curative resection，no statistical difference was observed （P=0.396，0.141，0.082，0.877，0.599，respectively）. Conclusion：The clinical manifestations of PSBA are unremarkable；diagnosis is mainly obtained at advanced stages，which indicates the poor prognosis. Surgical resection is the mainly treatment. Age，clinical stage and number of local invaded lymph-node may become the clinical index of survival time.