Background Acute abdomen refers to an urgent acute intra-abdominal event associated with inflammation, hemorrhage, obstruction, perforation, infarction or rupture of abdominal organs. Often, acute abdominal conditions require immediate and urgent surgical intervention. Aim The aim was to investigate the number of acute abdomens at the Clinic for Gynecology and Obstetrics in the period from 2005 to 2021. Methods A retrospective systematic study of the incidence of acute abdomen from the operating protocol of the clinic for the specified periods was conducted, with regard to the total number of operations per year, admission diagnoses with an indication for an operation, divided into etiopathogenetic factors and by age, and performed open operations or endoscopically. Results In total, data were analyzed for 703 (4.06%) patients out of a total of 17,311 operated patients. The most common diagnosis was from the group of hemorrhage (68.14%), followed by inflammatory genesis (25.60%), ischemia (8.69%) and other causes (3.6%). As many as 64% of operated patients were due to ectopic pregnancy. Laparoscopy (78.09%) and laparotomy (21.90%) were performed most often, mostly in patients aged 21-45 (74.40%). Conclusion The highest percentage of acute abdomens occurs between the ages of 21 and 45 (74.40%). We can also conclude that the largest number of emergency operations are performed laparoscopically (78.09%). With the mentioned method of surgery, the patient's recovery is faster and thus their stay in the hospital is shortened. The most common diagnosis is from category hemorrhage (68.14%).