<p> In this study, 150 cases of acute abdomen were taken. Study was done in surgery department of JLNMCH, Bhagalpur, Bihar from January 2015 to January 2016. All cases of acute abdomen were registered fulfilled the inclusion criteria. This study was done to see the incidence of non-traumatic, acute abdominal emergencies in our college. The disease was most common in the age group 20-40 years with male predominance. More than half of the acute abdomen was due to the acute appendicitis. Neutrophil leucocyte count had the highest sensitivity (91%) while Plain X-ray abdomen showed the highest specificity (90%) and positive predictive value (84%) in diagnosing acute abdomen. Urinalysis showed the highest negative predictive value (88%). Overall diagnostic accuracy was 80%, which was statistically significant (P<0.05). Diagnostic accuracy was highest in bowel obstruction (92%) and lowest in peritonitis due to viscus perforation (69%).</p>