Acute abdominal pain is common among patients admitted to the emergency department. The pain less than a week is called acute pain. Rapid evaluation and diagnosis of this type of patients have great value. The differential diagnosis is also important. Suspicion of acute abdomen syndrome does not always require urgent surgical approach. Diagnosis of acute abdominal pain in emergency department requires a good medical history, serial physical examinations and imaging techniques, together with laboratory tests for the diagnosis and differential diagnosis and more specific clinical diagnoses are needed for various biochemical markers. In this article, the importance of the missing anamnesis and the missing physical examination was emphasized and the approach to the patient with acute abdomen was evaluated.