1.1. Introduction: Acute abdomen accounts for 5-10% of visits to the emergency room (ER). An early and accurate diagnosis is essential in the management of these patients. Usually the first radiological investigation performed is an abdominal X-ray (AXR). However in most cases an AXR is unable to reach a diagnosis and the patient then has to undergo further investigations. In our study, we wish to establish in how many patients presenting to the emergency department with acute abdominal pain was an unnecessary AXR done, and did not lead to a final diagnosis.