Purpose of Review <p>This review explores common and critical diagnoses that frequently present with a primary complaint of abdominal pain with a special emphasis on conditions more frequently encountered in the emergency department geriatric patient.</p> Recent Findings <p>Trends toward less invasive treatments for conditions previously seen as entirely surgical including nonoperative management with antibiotics alone, endovascular and endoscopic therapies are changing the landscape of treatment for patients with intra-abdominal emergencies. The safety and efficacy of these treatment approaches can differ in the geriatric patient population when compared to the general population.</p> Summary <p>Geriatric patients with abdominal pain have a higher incidence of serious pathology and often require more liberal use of advanced diagnostics. Advances in treatment have made improvements in morbidity and mortality in many conditions, but there remains significant room for improvement.</p>