Background: Abdominal pain is a common presentation at the surgical department. Emergency laparoscopy in patients with "acute abdomen" is a part of common surgical practice. Aim: Evaluation of the role of laparoscopy in management of acute abdominal pain Methods: 100 patients with acute abdominal pain presented to the Department of Surgery, Al-Azhar University, El-Hussein and El Minia Health Insurance Hospitals were included in the study during the period from April 2018 to April 2019. They were divided into two groups: known preoperative diagnosis (therapeutic n= 67 patients) and unknown (diagnostic and therapeutic n= 33 patients). Their ages ranged between 12 and 60 years old (35 patients were males and 65 patients were females). Laparoscopy was performed for all patients under general anesthesia. Results: The definitive diagnosis was established in 99 % of cases. 64 % of those cases were managed successfully by use of laparoscopy and conversion rate was 33 %. Time required for each operation varied according to the procedure, intraoperative morbidity was 7 %, post-operative complications were 11 %. The mortality of study was 1%. Conclusions: laparoscopic intervention for abdominal emergencies is as safe, feasible and effective. It results in minor trauma, has a rapid postoperative recovery, and reduces morbidity. Laparoscopy can help to avoid unnecessary non- therapeutic laparotomies. It can also help to guide the operating surgeon for choosing the proper targeted incision.