Background: The acute abdomen is a condition that demands urgent attention and treatment, ranging from trivial to life threatening conditions. The aim of this study was to know in detail the epidemiology and outcome in non-traumatic acute abdomen.

Methods: An institution based, cross-sectional study was conducted from December 2019 to April 2020, at Department of General Surgery Govt. Medical College Kota Rajasthan. The study included 100 cases of non-traumatic abdomen.

Results: Non- traumatic acute abdominal pain was more common in 2^nd to 6^th decade of life. The males to female ratio is 2.85:1. Hollow viscus perforation (30%) forms the commonest cause of acute abdomen followed by acute appendicitis, Sub acute intestinal obstruction, renal/ureteric colic, cholelithiasis, pancreatitis, non-specific pain abdomen, OBG related pathology, liver abscess, Meckel’s diverticulitis and splenic abscess in 24%, 23%, 8%, 4%, 3%, 3%, 2%, 1%, 1% and 1% respectively. Sixteen patients managed conservatively. Most common surgical procedures done were exploratory laparotomy with needful for hollow viscus perforation and open/laparoscopic appendicectomy for acute appendicitis.

Conclusions: Proper history taking, clinical examination with supportive imaging findings are most important to narrow the differential diagnosis and for immediate intervention to limit morbidity and mortality.