The cause of acute abdominal pain during pregnancy is often difficult to establish due to the presence of multiple factors related to the pregnancy which can generate confusion and consequent diagnostic delay. Ultrasound is the first-line diagnostic test in pregnant women, but it can be limited due to the alteration of body habitus, the reduced field of vision, and the presence of hollow viscera overlying the pregnant uterus, interfering with the ultrasound beam. Magnetic Resonance Imaging is usually used when Ultrasound is insufficient; provides a complete evaluation of the abdomino-pelvic cavity with high diagnostic accuracy. Unfortunately, access to the method can be limited by the unavailability of the equipment and the frequent intolerance of the pregnant patient towards this type of investigation, burdened by long execution times and discomfort. Therefore, CT may be justified in pregnancy, in selected cases, when the study is in the best interest of the mother’s health and the patient is informed about the minimal risks to the fetus. Radiation exposure should be applied at the lowest levels reasonably achievable ensuring potential benefits that outweigh risk levels.