Abdominal emergencies in elderly patients can be difficult to diagnose and treat, due to medical comorbidities, atypical clinical presentations, and delays in seeking care. Computed tomography (CT) has emerged as the primary method of obtaining a rapid and accurate diagnosis in this population. This chapter begins by examining the ways in which scanning protocols should be adjusted for geriatric patients, including considerations of CT pitch, kVp selection, and contrast (both intravenous and oral). Specific diseases by organ system are then discussed with an emphasis on conditions which are particularly common in this age group or which have different manifestations in older individuals. As people age, changes in the appearance of the abdomen may mimic disease and these changes are noted. Key conditions of the gastrointestinal, hepatobiliary, pancreatic, genitourinary, and vascular systems that may be seen in elderly patients are reviewed. Finally, intraabdominal complications of medications that elderly patients may be taking can present on abdominal and pelvic CT, and some of the more common resulting conditions are presented.