Imaging techniques may lead to better insight in the diagnosis of the acute abdomen, and in specific cases to a more rapid diagnosis, especially in the upper abdomen. However, frequently the only result of the accessory diagnostic methods is delay of the necessary treatment. The yield of CT scanning in acute abdomen is too small to justify routine use. Ultrasonography is useful in selected cases, but not for routine application. Laparoscopic examination in acute abdomen in certain conditions facilitates making the correct diagnosis, but it constitutes an aggressive method for patients found free of abnormalities. Skillful history-taking and adequate performance of physical examination still constitute the basis of correct diagnosing. Technical aids may be of value. Good systematical studies of the clinical results and the cost effectiveness of physical examination and of the technological aids are still largely lacking.