With the continued population growth it is expected that greater numbers of patients will be consulting because of acute abdominal clinical conditions requiring integral and timely care. The elderly patient usually seeks medical care in advanced stages of disease and presents with coexistent morbidities that may adversely affect the course of the primary illness. Therefore, the correct diagnosis of abdominal pain becomes a real challenge to the physician, facing a person that generally presents absence of classical symptoms and signs, making the clinical presentation atypical. A significantly high number of these patients require an emergency operation with the corresponding adverse implications. The death of elderly patients presenting with acute abdomen frequently is due to delayed diagnosis, surgical intervention and the attending infectious complications that may lead to generalized sepsis, cardiac and pulmonary complications that exacerbate the comorbidities, conditions that are poorly tolerated by the person of advanced age. Thus the obligation of timely prevention, diagnosis and treatment in the elderly population.