Acute abdominal pain is one of the most common problems in children admitted to the pediatric emergency department (ED), and often presents a diagnostic dilemma for primary clinicians. Acute abdominal pain in patients presenting to the ED is often diagnosed as a disorder that does not require surgical intervention, such as acute gastroenteritis, functional digestive disorders or constipation. Objectives of our study: to evaluate various etilogies of acute abdomen in children presenting to paediatric emergency department and to estimate the prevalence of surgical abdomen in children presenting to pediatric emergency department. Methodology: Demographic information of the patients was noted down from the hospital case records, which include age, gender. Presenting complaints, clinical signs, etiologies of acute abdomen, laboratory investigations results TLC, DC, CRP, USG findings, CT abdomen findings, time and date of admission, daily progress, time and date of discharge were noted. In traumatic group apart of these observations additional lab investigations like amylase, lipase, ALT, AST, total protein and A:G ratio were noted. Results: We had a total of 132 subjects in non-traumatic group out of which 73% had acute appendicitis, 14% had incarcerated hernia, 7% had instussception, 5% had perforation and 0.75% had torsion.