In emergency surgery, rapid and precise decision-making is crucial, requiring the surgeon’s ability to assess multiple clinical, diagnostic, and environmental factors under high pressure. Recently, indocyanine green (ICG) fluorescence imaging has emerged as a valuable tool to enhance intraoperative visualization, with proven benefits in elective surgeries. In the emergency setting, ICG fluorescence imaging supports surgical decisions by providing real time, enhanced visual assessment of critical anatomical structures and tissue viability. This technology can reduce operative time, complications, and hospital stays by providing better guidance for minimally invasive and traditional procedures. Surgeons must acquire the necessary skills and utilize appropriate equipment to effectively implement ICG fluorescence angiography and cholangiography based on the clinical context and patient condition. Integrating advanced technologies such as ICG fluorescence into emergency surgery paves the way for more precision-guided interventions. It enhances the surgeon’s ability to assess bowel viability and identify the extrahepatic biliary ducts and ensure optimal outcomes in critical, time-sensitive situations where conventional methods may be limited.