While plain abdominal radiographs retain an essential place in acute abdominal emergencies, the dramatic advances in ultrasound, computed tomography and magnetic resonance imaging witnessed over the past two decades have revolutionized the practice of emergency medicine. Cross-sectional imaging techniques now play a key role in evaluating patients with abdominal emergencies, and allow confident diagnoses to be made in an ever increasing proportion of these patients. Unnecessary laparotomies are now uncommon, and a wide array of interventional radiological techniques can be used to treat abdominal emergencies without surgery.