Surgical emergency abdomen is an acute abdominal lesion caused by non-trauma that requires surgical treatment, due to the variety of diseases it includes. As a result, surgical acute abdomen with atypical symptoms and signs is very easy to be misdiagnosed. And acute appendicitis (including acute attacks of chronic appendicitis) as the most common cause of acute surgical abdomen. It is more likely that other surgical acute abdominal diseases with symptoms close to it are misdiagnosed, which brings great difficulties to the diagnosis and treatment work. The etiology of surgical acute abdomen is complex. In addition to surgical diseases. Abdominal pain can occur in gynecology, pediatrics, and systemic diseases. Since appendicitis is the most common cause of acute abdomen, it is most often misdiagnosed as appendicitis in clinical practice. As a general surgeon. It is not easy to make a correct diagnosis of surgical acute abdomen with atypical symptoms and signs, but must be made by detailed history, careful physical examination, relevant auxiliary examinations and comprehensive and reasonable analysis of the data obtained. Only then can accurate diagnosis be made. The necessary auxiliary examinations should not be neglected, and emergency ultrasonography is of great value in acute abdominal disease, especially for female patients with lower abdominal pain, ultrasonography is essential. Reasonable surgical exploration can become one of the means of diagnosis and treatment, as long as the systematic exploration, take the appropriate operation style. It is not difficult to misdiagnose but not to mis-treat. Especially in recent years, laparoscopic techniques have been widely used. For the diagnosis and treatment of acute abdominal disease has opened up a new field. Uncommon diseases causing acute abdomen include herpes zoster, tuberculous peritonitis, pancreatic duct hemorrhage, mesenteric thrombosis, etc.