Gastric dilatation is an acute and life-threatening condition in pet rabbits commonly caused by an intestinal obstruction with pellets of compressed hair. Surgery is normally considered to be the treatment of choice to alleviate the obstruction. However, for various reasons such as restrictions by the owner, a high anaesthetic risk due to the critical condition of the patient or concurrent diseases, surgical treatment may be impossible. In a three-year period, 145 cases of gastric dilatation were treated medically with a combination of metoclopramide, metamizole, balanced fluid electrolyte solution with glucose and syringe feeding. No gender or breed predisposition could be noted. Four animals were euthanased, three of them directly after diagnosis. Eleven animals died, eight of them on the day of presentation. The medical treatment was successful in 130 cases (89 per cent) with a mean treatment time of three days. The animals were released from hospital when eating and defecating normally. Although the use of medical treatment of gastric dilatation has to be thoroughly considered, especially regarding the severity of obstruction, the painfulness and the animal's welfare, the good survival rate observed with these animals makes it a good option for all cases where surgical treatment is contraindicated.