Purpose of the study. - Identify the epidemiological, clinical and therapeutic features of abdominal emergencies in the elderly. Patients and methods. – we performed a Retrospective and analytic study of 78 files of patients over 65 years admitted for acute abdominal pathology in the emergency department from January 1, 2015 to December 31, 2019. Results. - The patients, 58 men (74.4%) and 20 women (25.6%), had a mean age of 74.3 years (66–95 years). The clinicoradiological picture was suggestive of occlusive syndrome in about half of the cases (n = 37). The most common diagnosis was acute bowel obstruction (n = 28), followed by strangulated hernia (n = 24) and peritonitis (n = 13). A surgical indication was made in 74 patients and 4 patients received exclusively medical treatment. The mean time to surgery was 1 day (0 - 11 days). The main surgical procedures concerned parietal surgery (n = 24), colonic surgery (n = 15) and small bowel surgery (n = 13). The frequency of postoperative transfer of patients in intensive care was 23% (n = 18). The postoperative follow-up was straightforward for 44 patients. Morbidity concerned 5 cases. Overall mortality was 37.2% (29 patients) for all patients received, including 10.3% (n = 3) nonoperative mortality. Analysis of several factors showed that mortality was significantly related to the diagnosis of acute generalized peritonitis (p = 0.001), to transfer to intensive care (p = 0.0001) and to the occurrence of postoperative complications (p = 0.021). Conclusion. –The occurrence of acute abdominal emergencies in the elderly may have an atypical clinical presentation with a long course of action. The prognosis depends on the etiology, the presence of co-morbidity, the speed and effectiveness of management. Keywords: abdominal emergencies, elderly, mortality