Background: Due to the common problems after pelvic-abdominal procedures, the post-operative abdomen is tough. Hence, every radiologist must be extremely accurate in identifying these problems in order to rapidly identify potentially life-threatening situations and initiate necessary care immediately. Aim: To the early diagnosis and for adequate treatment planning through using the Multi-Detector Computed Tomography (MDCT) in the diagnosis of post-operative pelvi-abdominal surgical complications. Patients and Methods: This was a descriptive cross-sectional study carried out on 50 adult patients who were referred to the surgery clinic of Ismailia Suez Canal University and Ismailia General Hospitals suspected to have post pelvi-abdominal surgical complications. MDCT was done to all patients and the findings were interpreted by two specialty-certified radiologists. Results: Our results showed that the most common pre-surgical diagnosis was malignancy and recurrence in 38 patients (76%). Our study showed that recurrent malignancy was the most frequent findings, and 60% of the patients were managed conservatively. Conclusion: Computed tomography (CT) was used as gold standard tool in the evaluation of all patients included in this study as it is presently the workhorse to assess post-operative problems, with the exception of MRI for probable recurrence of rectal cancer or inflammatory bowel disease.