Traditional open exploratory surgery for peritonitis can have a negative rate of up to 22%. Emergency laparoscopic surgery not only allows timely diagnosis and management of abdominal lesions, but also enables some patients to avoid unnecessary open surgery. from January 2008 to May 2011, we have applied laparoscopic techniques to treat nearly 200 cases of acute abdominal diseases with satisfactory results. The types of diseases include acute appendicitis, acute calculous cholecystitis, biliary pancreatitis, gastroduodenal perforation, colorectal perforation, adhesive intestinal obstruction, closed abdominal trauma, etc. I. Acute appendicitis The negative dissection rate of appendicitis reaches 3%. Laparoscopic exploration is comprehensive to avoid missing, especially for those with unknown diagnosis, and laparoscopy can make a perfect combination of diagnosis and surgery. In addition, laparoscopic appendectomy has thorough abdominal flushing, significantly lower incision infection rate, comparable or less time than open appendectomy, comparable total hospitalization cost, and less complications. Acute calculous cholecystitis is feasible within 72 hours of the onset of laparoscopic cholecystectomy; for those who undergo laparoscopic surgery more than 72 hours later, it is confirmed that the gallbladder is wrapped by the large omentum, the gallbladder is heavily edematous, brittle, easy to bleed, more right upper abdominal exudate, the gallbladder triangle is densely adherent and “frozen”, and the anatomical structure is not clear. The operation is more difficult and should be performed carefully by experienced physicians. In order to avoid postoperative fluid accumulation, infection and observation of bile leakage and bleeding, a drainage tube should be placed next to the ventouse. Abdominal trauma can be life-threatening in serious cases, and early and correct diagnosis and timely treatment are the keys to reduce the morbidity and mortality rate and complications. Diagnostic laparoscopic exploration is safe and accurate, and provides a clear direction for open surgery in patients with heavy bleeding or serious degree of organ damage, avoiding delaying the timing of surgery due to the need for observation. Especially for the diagnosis of certain difficult diseases of the abdominal cavity has the irreplaceable role of other examinations, while also avoiding unnecessary open surgery. Fourth, ulcer perforation laparoscopic perforation repair has the advantages of simple operation, thorough flushing, convenient drainage and small incision, fast recovery and short hospital stay. It is believed that laparoscopic perforation repair is currently the most suitable surgical method for the popularization of ulcer perforation. For suspected tumors, intraoperative biopsy and rapid pathological examination are necessary to avoid missed diagnosis. In conclusion, emergency laparoscopy can not only clarify the presence, location and extent of lesions, but also complete resection, repair and reconstruction with minimal trauma, and even for operations that cannot be completed laparoscopically, the operator can be instructed to accurately select an open incision to reduce unnecessary trauma, thus having unparalleled advantages over traditional dissection. Nevertheless, we should also be soberly aware that because laparoscopy can only observe lesions on the surface of the organs and lacks the fine touch of the operator’s hand, it is easy to miss inter- and posterior organs in the abdominal cavity and damage to some intra-abdominal organs, so whether to perform laparoscopic treatment should depend on the situation, and if necessary, it should be decisively transferred to open surgery.