Abdominal pain accounts for approximately 10% of emergency department visits and 4% to 6% of litigation. Clinical history and examination are important, as all diagnostic testing has limitations. Specific pathologies, such as appendicitis, warrant a review of factors increasing risk. In all cases, documentation of prompt communication with consultants can be protective in the event of any unforeseen delays in care. Careful attention should be paid to special populations including patients with cancer, diabetes, and patients with postsurgical, geriatric, and bariatric surgery.