This chapter highlights important emergencies to be always considered in these patients that will require an urgent evaluation by a gastroenterologist in consideration of endoscopic intervention and/or a surgeon, in case surgery is required. In cases of emergency surgery for non-intestinal issues, the surgeon also needs to consider any possible risks that the underlying gut dysmotility poses in the perioperative period, such as pulmonary aspiration. Gastrointestinal motor or sensory dysfunction may or may not be symptomatically apparent or known at the time of surgical decision-making. Examples are underlying silent esophageal dysmotility or gastroparesis, both predisposing to aspiration, or small bowel and colonic dysmotility, potentially leading to prolonged postoperative ileus, or Ogilvie’s syndrome. Preferably, other (medical, radiologic, or endoscopic) options need to be explored first, again considering the benefit-to-risk ratio for each patient and what the long-term implications of such surgery might be on the neuromuscular function of the gut.