Introduction: Patients with abdominal pain frequently visit the emergency department (ED). Yet, there is limited research examining trends in ED utilization and subsequent hospital stays in patients presenting with this symptom. In this study, in addition to studying properties, we aim to examine factors associated with hospitalization from the ED in these patients. Methods: National Emergency Department Sample (NEDS) was interrogated to identify patients with primary discharge diagnosis of abdominal pain (The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes 789.0, 789.00-789.09,789.60-789.69) between 2006 to 2014. Demographic information, comorbidities, and ED charges were obtained. In patients who were hospitalized, hospitalization factors and charges were obtained. Descriptive statistics was performed. This was followed by multivariate survey logistic regression analysis to identify factors associated with hospitalization from the emergency department. Results: N=9,142,854 ED visits were identified. Between 2010-2014, the frequency of ED visits increased by 33.5%, whereas the proportion of patients admitted to the hospital for abdominal pain decreased by 48%. The per patient ED charges rose 100.2 %, and aggregate national cost rose by 167%, from $10 billion in 2006 to $27 billion in 2014 (Table1). Multivariate analysis identified female gender (OR [odds ratio], 1.09; 95%CI [confidence interval], 1.076, 1.105), tobacco use (OR, 1.802; 95%CI, 1.712, 1.897), alcohol use (OR, 3.593; 95%CI, 3.442, 3.751), obesity (OR, 5.245; 95%CI, 4.773, 5.763), and morbid obesity (OR, 6.555; 95%CI, 6.043, 7.11) as being associated with hospitalization. Compared to charleson comorbidity index of 0, those with 1 (OR, 2.61; 95%CI, 2.545, 2.676) or >1 (OR, 6.461; 95%CI, 6.222, 6.709) had increased odds of hospitalization. Weekend admissions are associated with decreased odds of admission (OR, 0.965; 95%CI, 0.954, 0.975). Additionally, older age, medicare insurance, and higher median incomes were associated with greater risk of hospitalization (Table2) Conclusion: We have examined the substantial burden of abdominal pain in ED, along with enormous (and increasing) costs associated with abdominal pain. Outpatient programs are needed to to prevent these unplanned events. Factors associated with hospitalization from the ED can be used to identify opportunities for reducing healthcare burden associated with abdominal pain.470_A Figure 1. - ED utilization statistics 2006-2014470_B Figure 2. - Multivariate analysis of factors associated with hospitalization from the emergency department in patients presenting with abdominal pain