Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are life-threatening conditions with a high mortality rate, making early detection crucial for optimal management. IAH is defined as intra-abdominal pressure (IAP) <12 mmHg. This can result from increased intra-abdominal volume (due to ileus, ascites, trauma, pancreatitis, etc.) and/or decreased abdominal wall compliance. IAH can lead to complications such as reduced venous flow, low cardiac output, renal impairment, and decreased respiratory compliance. These complications can progress to multiple organ failure and trigger ACS when IAP rises above 20 mmHg. Diagnosis is typically made at the bedside through bladder pressure measurement, though this is not always feasible. Therefore, alternative diagnostic techniques, such as computed tomography (CT), should be considered. CT can detect and characterize conditions leading to IAH, making it a valuable tool. Even if individual CT signs, such as elevated hemidiaphragm, and flattened inferior vena cava, are neither sensitive nor likely specific for ACS, their combination in the appropriate clinical setting should raise the suspicion of ACS. The early diagnosis of IAH/ACS is very important because it could potentially improve the management and the outcome of these patients.