Over the past 20 years, CT has become the premier imaging technique for evaluating patients presenting with symptoms of acute, severe, abdominal pain. The advent of multidector helical CT (MDCT) has improved the accuracy and expanded the indications for CT of the acute abdomen. MDCT is accurate for nearly all of the numerous etiologies of conditions that require emergency medical or surgical treatment. The proper execution and interpretation of CT in this setting reduces morbidity, mortality, and medical expenses.