Emergency Department (ED) is an autonomous part of the hospital's immediate readiness. Acute abdominal pain is the most frequent reason why patients seek medical help in the ED. Aim: The purpose of the present study was to explore the management of acute abdominal pain in the ED of a provincial hospital. Material and Methods: The sample studied included 933 patients aged> 14 years who visited the ED of provincial General Hospital, with abdominal pain from January 2010 to January 2011. In every patient the sex, age, physical examination findings and laboratory and imaging results, treatment and outcome were recorded. The data were analyzed with the statistical package SPSS, version 13.00. Results: 44. 2% (n = 413) of the studied population were men with mean age 42.3 ± 21.6 years. There were no differences in clinical presentation, laboratory results and medication administered in relation to sex or age, (p<0.05). The comparison between elderly and younger patients showed no differences regarding the clinical picture and treatment. Although elderly patients were at a significantly higher percentage subjected to ultrasonography and CT scan of the abdomen and had significantly higher rates of hospitalization (p<0.05), no differences were found in the need for immediate surgery. The patients admitted to the hospital were men, elderly, febrile and tachycardic, had leukocytosis and signs of peritoneal irritation (p<0.05). There were no statistical differences in the management and outcome in terms of ethnicity or insurance status. Conclusions: Abdominal pain management in ED is an important process for patients' outcome. Conducting laboratory and paraclinical examinations is the basis for the correct diagnosis, the proper patients' treatment and good patient's outcome.